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VOLUNTEER ONLINE

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Section A - General Information

Personal Info

First Name:

Street:

Town/City:

Home Phone:

Last Name:

PO Box:

Postal Code:

Work Phone:

Email:

Emergency Contact

	First name	Relationship	Home Phone	Work Phone
Contact1
Contact2

Section B - References

List three persons who have knowledge of your qualifications. References should have known you for a minimum of two years.

	First name	Relationship	Phone	Years Known
Reference1
Reference2

Agreement: *

I agree

The screening process of Home and Community Support Services of Grey Bruce includes an application form, an interview and reference checks. Upon receipt of a conditional offer of a position, please note that some positions may also require additional checks such as driving licenses, insurance confirmation and police checks.

NOTE: By entering Reference information and pressing the "Submit" button, you give permission for the references listed above to be contacted in connection with my application for a volunteer position with Home & Community Support Services of Grey-Bruce.

St. Francis Place, Suite 104	Call: 519-372-2091	Our office is open from 8:30 to 4:30 Monday to Friday.
340 10 th St.East	Fax: 519-372-2748
Owen Sound, ON, N4K6P7	Email: mailbox@hcss-gb.ca

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