GENERAL VOLUNTEER APPLICATION FORM
Fields marked with an asterisk
*
are mandatory. All other fields are optional.
Contact Information
First Name
Last Name
Pronouns
Please select...
He/Him/His
She/Her/Hers
They/Them/Theirs
Ze/Hir/Hirs
Prefer to self-describe
Prefer not to disclose
Self-describe
Email
Phone
Street Address
City
Province
Please select...
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Québec
Saskatchewan
Yukon
Postal Code
Country
About You
What connection, if any, do you have to MS?
Please select...
I live with MS
I am a caregiver to someone living with MS
A family member lives with MS
A friend lives with MS
A coworker lives with MS
I have no connection
I prefer not to disclose
Other
Specify Connection
Are you 18 years of age or older?
Yes
No
Date of Birth
MM/DD/YYYY
In what language(s) are you fluent?
English
French
Other
Other Language(s)
Areas of interest (check all that apply)
Administration (ex. data entry, research and compile information)
Advocacy (ex. meet with elected officials, help people with MS access funding)
Community events (ex. help at a food station, assist with event check in)
Event planning (ex. organizing committee for MS Walk or MS Bike)
Group opportunities (ex. volunteer with your team from work)
Marketing and communications (ex. creative writing, graphic design)
Media (ex. print, radio, tv)
Peer support (ex. lead a support group, provide one-on-one phone support)
Public speaking (ex. share your story at an event, moderate an educational presentation)
Represent MS Canada in your community (ex. build community partnerships, promote MS Canada events and initiatives)
Wellness (ex. facilitate a virtual wellness session)
Youth / young adult opportunities (ex. community building with other young adults under 39)
Emergency Contact
First Name
Last Name
Relationship
Email
Phone
Communication Preferences
(please select all that apply)
I would like to receive emails from MS Canada regarding upcoming volunteer opportunities
I would like to receive emails from MS Canada about the organization, its impact, and other ways I can help. I can withdraw my consent at any time
Additional Information
Is there anything else you would like us to know?
Volunteer Waiver, Policies and Procedures
Code of Conduct and Ethical Behaviour
Click here to read
I agree
I do not agree
IT Acceptable Use Procedures
Click here to read
I agree
I do not agree
Privacy & Confidentiality
Click here to read
I agree
I do not agree
Volunteer Waiver Agreement
Click here to read
I agree
I do not agree
Respectful Workplace & Environment Policy
Click here to read
I agree
I do not agree
AODA
Click here to read
I agree
I do not agree
COVID Measures Support Statement
As a member of the MS Community, I acknowledge that the safety and health of the MS Community is our top priority. I support efforts to safeguard the health of people living with MS, our families and our friends by following recommended public health measures like washing my hands frequently, wearing a mask when in close proximity to others in an indoor space, and staying home if I feel sick.
I agree
I do not agree
Privacy
Statement
MS Canada collects the personal information of volunteers for the purpose of communicating information to you about MS Canada and its programs, events and volunteer opportunities, and to compile anonymous statistical information. By completing this form, you acknowledge and consent to the collection and use by MS Canada of your personal information for these purposes. If you have any questions about your personal information, or MS Canada’s privacy policy please contact our Privacy Officer at
priv@mscanada.ca
.
I agree
I do not agree
Adult applicant sign off
Name
Date
Signature
Please re-type your name to complete the sign off process.
Youth applicant sign off
Name
Date
Signature
Please re-type your name to complete the sign off process.
Parent/guardian sign off
Parent/guardian Name
Date
Signature
Please re-type your name to complete the sign off process.
We are committed to accommodating volunteer’s needs throughout their journey with us. Please contact
volunteer@mscanada.ca
should you need accommodation.
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