Welcome to Interior Healths Volunteer Portal

Volunteer Application

Volunteer Application


Personal Information
Application Entry Date
First Name
MI
Last Name
Preferred location
Home Address
City
Province
Postal Code
Home Phone
Cell Phone
Work phone
E-mail Address
Person Type
DOB
Gender


Emergency Contact Information
Contact name
Contact Phone

Medical Information
Wheelchair/requires handicap access
https://justice.gov.bc.ca/eCRC/
Medical alert
Language
Job preferences (as checklist)
CRC ID NUmber
References; please provide contact information for 2 people
References
References # 2