Volunteer Application Form

Contact Information Name:
Title / Position:
Address:
City:
Province:
Postal Code:
Telephone:
Email:

Preferred Location and Times

Below are the available locations and times, when making your selection, please select the timeframe(s) from location(s) of your choice.

Dartmouth Mondays and Wednesdays only
3:50PM - 4:50PM
5:00PM - 6:00PM
6:10PM - 7:10PM

Halifax Mondays and Wednesdays
3:50PM - 4:50PM
5:00PM - 6:00PM
6:10PM - 7:10PM

Tuesdays and Thursdays
4:20PM - 5:20PM
5:30PM - 6:30PM
6:40PM - 7:40PM

Mount Saint Vincent Tuesdays and Thursdays
5:00PM - 6:00PM

First Reference

Name:
Position:
Organization:
Phone:
Email:
Relationship with this person:

Second Reference

Name:
Position:
Organization:
Phone:
Email:
Relationship with this person:

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