Volunteer Application Form "*" indicates required fields Step 1 of 6 – General Information 0% Thank you for your interest in volunteering with Bereaved Families of Ontario – Midwestern Region. Please take a moment to provide us with some information about you. Volunteer position you are applying for:* Your Name* First Last Email* Phone*Address* Street Address City State / Province / Region ZIP / Postal Code Employment HistoryCompany/Organization #1 Start Date End Date Positon/Role Company/Organization #2 Start Date End Date Position/Role Dates Company/Organization #3 Start Date End Date Position/Role Volunteer HistoryOrganization #1 Start Date End Date Position/Role Organization #2 Start Date End Date Position/Role Organization #3 Start Date End Date Position/Role Skills & AvailabilityPlease list the skills you possess which will be beneficial in the volunteer role you are applying for:*Are you available: (please check all that apply)* Mornings Afternoons Evenings Weekends Do you see yourself volunteering:* Less than a year More than a year Approximately how many hours per month are you available to volunteer?* Please tell us why you would like to volunteer with Bereaved Families of Ontario – Midwestern Region:* ReferencesPlease provide contact information for three references (NOT family members or friends):Reference #1 Name* First Last Phone*Relationship to you* Reference #2 Name* First Last Phone*Relationship to you* Reference #3 Name First Last PhoneRelationship to you Consent I agreeBy clicking this check box, you are confirming that the information you have provided is complete and accurate. The information on this application is collected to determine eligibility for Bereaved Families of Ontario – Midwestern Region volunteer opportunities and to safely, effectively, and responsibly implement our volunteer program in accordance with the Freedom of Information and Protection of Privacy legislation.