| Name: |
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Date of Birth: |
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| Address: |
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Postal Code: |
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| Phone Number: |
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Home: |
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| Work: |
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Contact in case of emergency: |
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| Do you have previous experience as a volunteer? |
Yes No |
| If yes, with whom? |
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| How did you learn about our agency? |
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| Why do you wish to become a volunteer with the Elizabeth Fry Society? |
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| Do you have any reservations about working with offenders? |
Yes No |
| What kind of skills or information do you wish to acquire through this volunteer position? |
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| Are you available for volunteer work: |
Regularly Occasionally |
| When are you available? |
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| Date available to begin volunteering: |
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| Do you have a valid driver's license? |
Yes No |
| Languages spoken: |
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| If yes, are you employed: |
Full time Part time |
| Present type of work: |
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| Past type of work experiences: |
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| If you are a student, what programs are you enrolled in? |
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| Please state any previous education, vocational training, or courses that you have completed: |
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| Do you have any skills, interests, or hobbies, (crafts, music, drama, etc.) that are related to this volunteer assignment? |
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| Please feel free to add any relevant information in the space provided: |
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