Volunteer Form - Alberta Lung

Your Name (required)

First

Last

Address (required)

Address Line 1

City

State / Province / Region

Postal Code

Phone

Email (required)

Are you over the age of 18? (required)

Yes
No

Let us know the frequency that you would like to volunteer so we can match you with the perfect position. (required)

Please let us know any additional information, such as your availability or if there is a particular position or project you are interested in.

Why do you want to volunteer for Alberta Lung?

Please list your specific areas of interest (if any):

Please name specific event(s) you wish to volunteer for (specify name, date, city):

Which skills and attributes do you have that you would like to share with Alberta Lung?

Have you ever been employed by and/or volunteered with Alberta Lung, or any of it's affiliates?

Please list any previous and/or current volunteer activities:

Have you ever been convicted of a criminal offence for which a pardon has NOT been granted? (required)

Yes
No

References (required)

Alberta Lung seeks to protect volunteers, employees, and the community through appropriate screening measures. Reference checks are required for all employees and volunteers. Please provide names and phone numbers of two references that we may contact.

Permission to contact references (required)

Yes
No

By checking above, I certify that the information provided in this application is correct and complete. I give my permission to Alberta Lung to contact the above references and to obtain, if required, a criminal record check. I understand I will be advised in advance if a criminal record check is required. I am aware that I may become privy to private information about the Association or the people for whom it services. I agree to hold this information in confidence and not to discuss it with anyone other than those properly concerned.