Quality primary health care services

Online Volunteer Form

The Chatham-Kent Community Health Centres offer volunteer opportunities for anyone 14 years of age and over.

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Occupation*
Age*
Phone*
What is the best time to call you?*
Email*
Spoken Language(s)
Please list all your current and past volunteer positions and experience:*
*
The CKCHC is committed to providing accommodations to persons with disabiltiies. If you require an accommodation we will work with you to meet your needs. Should you require accommodation during the volunteer recruitment process or during your placement, please list any requirements below, or contact Human Resources at 519-397-5455 or hr@ckchc.ca for additional information.
What do you hope to gain from volunteering?*
Where did you hear about our organization?*
What areas within the centre would you be interested in volunteering for?*
- Senior Programs
- Youth Programs
- Social Skills Programs
- Healthy Living
- Social Activities
- Physical Fitness Programs
- Client Advisory Committee (must be a client or caregiver of client)
- Cooking
- Other
Availability (please check all that apply)*
- Monday AM
- Monday PM
- Tuesday AM
- Tuesday PM
- Wednesday AM
- Wednesday PM
- Thursday AM
- Thursday PM
- Friday AM
- Friday PM
I acknowledge that the information provided in this application is true and has been completed to the best of my ability. I understand that this is an application to participate in a volunteer program for which there will be no financial compensation and responsibilities as a volunteer at the Chatham Kent Community Health Centres will be established for the purposes of fulfilling specific program requirements.*
- I agree
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The Best Possible Health and Wellbeing For Those We Serve

Online Volunteer Form

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