The AIDS Commitee of
North Bay and Area

Application for Volunteers

Phone: 497.3560 Fax: 497.7850
201-269 Main Street West North Bay, ON P1B 2T8
www.aidsnorthbay.com email: jfurtney@efni.com

Please complete the following questions to be considered for volunteer service at the AIDS Committee of North Bay and Area

Student?  Yes   No  School 
Name 
Address   Postal Code
Home Phone 
Email 
Occupation    Work Phone
Can we say it's the AIDS Committee calling? Home:  Yes  No Work:   Yes  No

CONTACT IN CASE OF EMERGENCY
Name:   Phone: 
Relationship:   Father    Mother    Other
Do you have a valid drivers license?  Yes  No
Do you own a vehicle or have access to one?  Yes  No
Do you Speak French?  Yes  No
Do you speak any other languages?  

AVAILABILITY CHART
DAYS MORNING AFTERNOON EVENING ANYTIME
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Why do you want to volunteer for the AIDS Committee?

Do you have previous volunteer experience? If so, please list.

Educational Background:

Do you have any health restrictions? If so, please list.

COMPUTER SKILLS
Programs Check
Mark		 Programs Check
Mark
Microsoft Work Microsoft Excel
Microsoft Publisher Microsoft Access
Graphics Internet Reasearch
Mail Merge Tables

Other Computer Skills

What do you know about the AIDS Committee of North Bay & Area and its Mandate?

How would you rate your level of knowledge about HIV/AIDS?
 POOR  GOOD  EXCELLENT

What do you hope to gain from your volunteer experience?

What areas are of more interest to you? (Please check in the box on the left)

 Administration includes :

  • Reception / answering phones
  • Mail-outs
  • Photocopying
  • Filing
  • Newsletter production
  • Resource organization
  • Computer work: data base, mail merge etc...

 Education / Outreach includes :

  • Display tables / booths
  • Pamphlet / poster distribution
  • Train the trainer
  • Public education training / speaking
  • Condom blitz

 Fundraising includes :

  • Ticket sales / booths
  • Raffle organization
  • Special event committees
  • Phone promotion
  • Red Ribbon Campaign
Can you make a commitment of at least one year?  Yes   No 



Applicants' signature
Date