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Volunteer Form
Your Information
Name
(Required)
First
Last
Address
(Required)
Street Address
Address Line 2
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Virgin Islands, U.S.
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Country
Phone
(Required)
Email
(Required)
Emergency Contact
(Required)
First
Last
Emergency Contact's Phone
Are you a
(Required)
Student
Adult
Volunteering
PLEASE INDICATE AVAILABILITY BELOW
Sunday
Morning
Afternoon
Any Time
Monday
Morning
Afternoon
Any Time
Tuesday
Morning
Afternoon
Any Time
Wednesday
Morning
Afternoon
Any Time
Thursday
Morning
Afternoon
Any Time
Friday
Morning
Afternoon
Any Time
Saturday
Morning
Afternoon
Any Time
What areas are you interested in volunteering? Please select all that apply.
(Required)
Recreation
Grounds
Alumni Weekend
Kitchen
Are you currently in recovery?
(Required)
Yes
No
If Yes please indicate your length of sobriety
Under 1 year
1 year
2-3 years
4-8 years
9+ years
**Please note a minimum of 1 yr sobriety is required**
Why do you want to volunteer for the Thorpe Recovery Centre?
(Required)
How did you hear about the Thorpe Recovery Centre?
(Required)
Newspaper
Internet
Alumni
Agency
Referral
Friend/Relative
Other
If other, please let us know the details
Let us know who referred you
Traits
Skills
(Required)
Do you have any recreational activities skills?
(Required)
Yes
No
If yes, please describe
General Interests
(Required)
Driver's License
Do you have a Driver’s License?
(Required)
Yes
No
Are you willing to utilize your own vehicle?
(Required)
Yes
No
A Driver’s Abstract will be required if assigned duties involve transportation of clients in TRC vehicle
Record of Offences
Background checks will be required for all selected volunteers.
Do you have a Criminal Record?
(Required)
Yes
No
Evidence of offences may or may not preclude your application.
Work / Volunteer History
Work Experience
(Required)
Profession
(Required)
Current Employer
(Required)
Position
(Required)
Other Volunteer Experience
(Required)
Have you ever been an employee, client or former volunteer at TRC?
(Required)
No
Employee
Former Client
Volunteer
Please indicate the reason for leaving?
References
Name
Phone
Name
Phone
Name
Phone
CONDITIONS OF VOLUNTEER PLACEMENT (Please read carefully)
I agree
1. I agree to comply with Volunteer Services requirements and policies as outlined in the Orientation
Manual, Position Description and TRC’s Code of Conduct.
2. I will be punctual and carry out my duties to the best of my abilities.
3. I will notify TRC of any necessary absence from my services as far in advance as possible.
4. Prior to starting my volunteer placement, I will have attended an orientation.
5. As a volunteer for TRC I agree to abide by and follow the TRC Confidentiality Agreement and Code
of Ethics.
6. As a volunteer for TRC I agree to hold in strict confidence, any confidential client and operational
information that I may come in contact with in my role as a volunteer.
All of the information contained in this application is true and that the misrepresentation of any part of this
application will be just and sufficient cause for termination of my volunteer placement.
I understand that all of my information, personal or otherwise, collected by TRC during the term of my
volunteer placement may be viewed by supervising managers within the Centre in considering me for a
volunteer position.
I understand that I am not an employee of TRC and that any duties that I perform are as a volunteer. I
agree to abide by the procedures set forth by TRC for my assigned work duties. I also understand that it is
my responsibility to update any address, emergency or other changes to the information of this form.
I, herby release TRC, its staff, Board, donors, sponsors ad volunteers from all claims in respect to death,
injury, loss or damage to my person or property arising from my participation in programs, classes,
activities sponsored by TRC or participation in activities for TRC as an active participant or spectator.
TRC reserves the right to refuse placement.
Release of Information
I agree
I give TRC permission to obtain or release information pertaining to my volunteer work or the purpose of a reference
Media Consent
I agree
I consent to have a picture/videotape/interview of me for the purpose of obtaining material which
may be used in a brochure, internet web page, news story, feature or broadcast for promotional
material for TRC:
Signature
(Required)
If accepted as a volunteer I agree to follow the above.
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