Sexual Assault Support Centre of Waterloo Region

Sexual Assault Support Centre of Waterloo Region

Volunteer Application Form
Date

MonthDayYear
Date
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Are you over the age of 18?

YesNo
Gender
Pronouns (ex. She/Her, They/Them, He/Him)
Occupation
Are you a student?

YesNo
If so, where and in what program?
The following roles are for cis women, trans women and non-binary people only:

Support Line VolunteerSupport Chat VolunteerGroup and Workshop Facilitation Volunteer
The following roles are for people regardless of gender:

Public Education Volunteer

What is your availability?

What languages do you speak, in addition to English?
Are you currently or have you previously used SASC services? If so, when was the last time that you used them?
How do you define sexual violence? Why do you think sexual violence occurs?
Why do you feel SASC is a good fit for you? Explain.
What skills, experience and strengths do you possess that you feel will benefit SASC?
How did you learn about our volunteer opportunities?
If Other, Please Specify.
I hereby declare that the above information is true and complete to the best of my knowledge. I understand that a false statement may disqualify me from further consideration as a volunteer or result in dismissal.

YesNo
Please be aware that a Vulnerable Sectors Check is required for all staff and volunteer positions. If you have any concerns about the police check please feel free to speak with the Volunteer and Support Line Coordinator. Additionally, a confidentiality waiver and SASC Volunteer agreement forms will also need to be signed.
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