ASD SUMMER CAMP VOLUNTEER APPLICATION FORM
VOLUNTEER INFORMATION Last Name First Name Permanent Address City Postal Code Cell Phone Brock Email Alternate Email Program of study
EMERGENCY CONTACT Name Relationship Phone number Address
RECORD CHECK
Have you ever been convicted of a criminal offence for which a pardon has not been
granted?
YES NO *you may be required to submit a police vulnerable sector screening
Please disclose any reason why you should not be working with youth and young adults with a physical or developmental disability:
IMPORTANT REMINDERS
Please insure that applications are clear and complete. Please note, transportation to and from Brock University is the responsibility of the volunteer. Interested volunteers should be prepared to provide support for toileting as well as changing into and
out of swim attire. Your attendance and participation in training is mandatory prior to beginning your volunteer
experience. Email completed applications to [email protected] If you have any questions or concerns, please email [email protected]
ASD SUMMER CAMP VOLUNTEER APPLICATION FORM
BACKGROUND How did you learn about ASD Summer Movement Camp?
State the reason(s) you are interested in volunteering: What relevant work, education or training experience do you have? May we use photos or videos of you to promote ASD Summer Movement Camp? YES NO
Signature:
Date: