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Language oEnglish oOther(s) please list:___________________________________ |
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Education oHigh
School
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University oCollege
Diploma oPost-graduate oTrades certification oWork-related experience |
Past
Volunteer Experience
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DUTIES |
DATE (from-to) |
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SKILLS:
___________________________________________________________
TRAINING:
____________________________________________________________
Why are you interested in becoming a Child
Welfare Community Council Member volunteer?
____________________________________________________________
What do you think about the relationship
between Aboriginal people and the child welfare system?
____________________________________________________________
Considering your life experience, identify
three gifts or skills you bring to the program that might help someone expand
their horizons and build their self-confidence:
____________________________________________________________
Please
volunteer one day a month. Please check the days in
which you are available
Ö
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Hearing Availability |
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Times |
Monday |
Tuesday |
Wednesday |
Thursday |
Friday |
Saturday |
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Noon ~ 5pm |
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5pm ~ 9pm |
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When can you start:
______________________________________________________
ALST provides a meal for council members before
a hearing. Do you have any special meal needs:
____________________________________________________________
____________________________________________________________
Do you want the hearing schedules, memos,
availability list:
mailed to your home: ______________________
office:__________________________________
and/or
emailed to your home: _____________________ office: ______________
References
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Name |
Nature of Relationship |
Contact Number |
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1) |
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2) |
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3) |
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*Note that at least one reference must be of Aboriginal descent. Please
list only those we may contact.
____________________________________________________________
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PLEASE
NOTE An individual will
not be able to serve as a Child Welfare Community Council member if he or she
or his or her spouse is currently employed by a child welfare
organization. Nor can a person serve
as a Council member if she currently has an open file with a child welfare
organization or has had a file open with such an organization in the past two
years. It is not that
individuals who work with child welfare organizations or have open files with
such organizations cannot be good Council members – rather it is important
that all parties feel that Council members are approaching the issue at hand
with an open mind and free of any biases or the appearance of bias. Also, for the safety of our youth and adult
participants, we do require a criminal reference check. A criminal record does
not prevent a person from being a volunteer. Do you have any objections to
providing a criminal reference check. oYes oNo |
STATEMENT OF CONFIDENTIALITY
The
Community Council Program recognizes the right to the confidentiality and
privacy of our participants and volunteers, and is dedicated to serving the
community in only the highest ethical standards.
The
Community Council Program is committed to protecting the privacy of its
participants and volunteers. All information and disclosures will remain
confidential. Any information disclosed prior to and during a scheduled hearing
will remain confidential and will not be discussed with anyone.
SIGNATURE
OF VOLUNTEER APPLICANT:
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Date: --------------------------------