Volunteer Application

    Contact Information

    First Name *

    Last Name



    City, Province, Postal Code

    Home Phone

    Cell Phone

    Work Phone

    E-Mail Address (Primary) *

    E-Mail Address (Secondary)


    Birthdate (Month and Day Only)


    Preferred Gender Pronoun

    Are you a current employee?

    Are you a former employee?

    Languages spoken?

    Current Education Status


    During which hours are you available for volunteer assignments? (check all that apply)

    Weekday morningsWeekday afternoonsWeekday evenings


    Tell us in which areas you are interested in volunteering

    AdministrationCommitteesCommunity on CampusDay SupportsEventsMarch BreakResidential SupportsSummer Teen Activity ProgramTogether We Are Better Interest Based VolunteeringWeekend Respite ProgramsUnsure

    Special Skills or Qualifications

    Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies, interests or sports. (Please list – specific activities clubs or groups)

    How did you hear about Community Living Mississauga?

    Search EngineGoogle AdsFacebook AdsYouTube AdsOther paid social media adsFacebook post/groupTwitter postInstagram post/storyOther social mediaEmailRadioTVNewspaperWord of mouthOther

    Why are you interested in volunteering with Community Living Mississauga?

    Previous Volunteer Experience

    Summarize your previous volunteer experience.

    Person to Notify in Case of Emergency


    Relationship to you

    Primary Phone

    Agreement and Signature

    By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

    Name (printed)



    If under 17 - Name & Signature of Parent/Guardian

    Name (printed)



    Our Policy

    It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.
    Thank you for completing this application form and for your interest in a Student Placement at Community Living Mississauga.