Shoppers Home Health Care

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Fields marked with an * are mandatory

What are your details?

1. Personal Details

* Salutation
* First Name
* Last Name
Middle Name
* Email
* Age Group
* Are you a student?
* If yes, indicate level

2. Contact Info

* Home Address
* City
* Postal Code
* Province
* Day Phone
Evening Phone
Cell Phone
Fax

3. General Information

* Do you have a valid driver's license?
Do you have your own vehicle?
If you will be in direct contact with the athletes, you will be required to submit to a Police Check. Are you willing to have a police check conducted?
If you are a high school student, do you require a certificate of participation that records the number of hours you have volunteered for the Games?
* What size of volunteer t-shirt would you like?
Are you able to perform an active position that may involve heavy lifting?
* I give permission for my information to be saved as a volunteer at future Ontario Games
Relevant Volunteer/Work Experience
Please specify any special dietary needs

4. Availability

Are you willing to help prior to the Games?
Are you willing to help during the Games?
Please describe all times which you will not be able to assist during the games.

5. Emergency Contact

* Emergency Contact Name
* Emergency Contact Day Phone
* Emergency Contact Evening Phone
* Emergency Contact Address
* Emergency Contact Relationship

6. Language

English
French

7. Which volunteer roles you are interested in?