Volunteer Registration (Avalon East) - JA Newfoundland and Labrador

Volunteer Registration (Avalon East)
Title 1:		*
First Name:		*
Last Name:		*
Preferred Email:		*
Home Phone:		*
Home Country:		*
Home Mailing Address:		*
Home City:		*
Home Province:		*
Home Postal Code:		*
Gender:		*
Personal agreement to JA using name and/or picture:		*
Personal agreement to school year responsibilities:		*
Personal notes / comments:
Vol/Edu language to deliver/receive programs:	English Français Both	*
Volunteer employer / school:		*
Volunteer employer / school city:
Volunteer employer / school mailing address:
Volunteer employer / school postal code:
Volunteer employment status:		*
Volunteer interview CP handled tough youth issues:		*
Volunteer interview CP hope to convey to students:		*
Volunteer interview CP willing police record check:		*
Volunteer interview criminal offense conviction?:		*
Volunteer interview expected challenges:		*
Volunteer interview past volunteer experience:		*
Volunteer interview strengths / prof experience:		*
Volunteer interview why do you want to volunteer:		*
Volunteer JA programs taken as a student:
Volunteer last school year to volunteer with JA:		*
Volunteer other province/country where volunteered:
Volunteer reference 1 email address:		*
Volunteer reference 1 name:		*
Volunteer reference 1 phone number:		*
Volunteer reference 1 relationship:		*
Volunteer reference 2 email address:		*
Volunteer reference 2 name:		*
Volunteer reference 2 phone number:		*
Volunteer reference 2 relationship:		*

Account Information
Username:		*
Password:		*
12 characters or more.
Confirm Password:		*

Terms and Responsibilities:

By applying to be a Junior Achievement (JA) volunteer and submitting the Volunteer Application Form, I hereby declare that all information is accurate and complete.
- I agree to uphold the core values and mission of JA
- I authorize JA to contact the above references in connection with my volunteer application
- I understand that I may be required to provide further information in order to validate my volunteer status, including, but not limited to, providing a Police Records Check and/or a Vulnerable Sector Screening
- I release and hold harmless the above references and JA from any liability

Avalon East

• Volunteer

• Student

Avalon West to Gander

• Volunteer

West of Gander
and Labrador

• Volunteer