Volunteer Application Form – Telecare Distress Centre of Peterborough

Name *

First

Last

Email *

Address with Postal Code *

Preferred Telephone Contact # *

Best Time To Call?

Are you 18 years or older? *

Yes
No

How did you find out about volunteering with Telecare Peterborough? (check all that apply)

Other or More Details

What prompted you to apply for training?

Have you used Telecare or other Distress Line Services?

If yes to above, when?

Do you intend to become a Telecare volunteer if invited to do so after completing 50 hours of training?

Yes
No

If yes to above, what is your reason for wanting to volunteer?

Other

If no to above, please tell us your reason for taking this course

Are you currently volunteering or have you volunteered in the past

Yes
No

If yes to above, please describe where, when, for how long and what your duties were

Have you had previous experiences that you think would be helpful to you volunteering with Telecare Peterborough? Please specify

Please list any physical limitations we should be aware of, if any.

Will you require assistance with the $50 training fee?

Yes
No

By checking this box, I understand that to become a member of Telecare Peterborough, I must be willing to take the full training, and that my membership is probationary for the first six months. Membership commitment is renewed annually. *

I Agree

By checking this box, I also understand that volunteering on the phone line means answering calls on-site in Peterborough. i also understand that I will be asked to volunteer the equivalent of one 4-hour shift every two weeks. *

I Agree