Want to become a volunteer? Apply now!

Your Name

Email

English: and note:

Phone number

Street Address

City

Postal Code

Emergency Contact Name

Emergency Contact Phone #

Areas of Opportunity

Please indicate which area of volunteer involvement interests you: *

Availability

Weekly Shift
On Call
One Time / Special Event

Monday

Morning
Afternoon
Evening

Tuesday

Morning
Afternoon
Evening

Wednesday

Morning
Afternoon
Evening

Thursday

Morning
Afternoon
Evening

Friday

Morning
Afternoon
Evening

Saturday

Morning
Afternoon
Evening

Availability information and any restrictions that may be of note:

Skills and Experiences

Previous work/volunteer experience: *

Special skills and experiences including fluency in languages other than English:

References & Authorization.

You will be provided with a form that must be completed by two references. References can be of a personal and/or professional nature. The references you choose may not be a family member. Your participation with West Haldimand General Hospital will proceed when screening and training have been completed. WHGH collects your personal information in order to help identify suitable volunteer opportunities for you. Only authorized staff and/or volunteers access this information. Please be advised that we cannot always place a volunteer in a volunteer position. All adult (18+) applicants must provide a Police Reference Check with Vulnerable Sector Query prior to placement. By submitting this application form, you are authorizing WHGH to use the content for the purpose of processing this application.