Volunteer Application Form

Full Name

Address

City

Postal Code

Home Phone

Work Phone

Cell Phone

Email Address

Which method is best to contact you? Home Phone Work Phone Cell Phone Email

How did you hear about Sudbury District Restorative Justice?

Other

Please place checkmarks to indicate your availability.

Tuesdays

Morning
Afternoon
Evening

Wednesdays

Morning
Afternoon
Evening

Thursdays

Morning
Afternoon
Evening

Fridays

Morning
Afternoon
Evening

Saturdays

Morning
Afternoon
Evening

Sundays

Morning
Afternoon
Evening

Are you able to make a 1 year commitment to Sudbury District Restorative Justice?

Languages spoken and written (including sign language).

Please give the names and telephone numbers of three references. (Two professional and one personal)
Reference #1: Name, Telephone, Email

Reference #2: Name, Telephone, Email

Reference #3: Name, Telephone, Email

I give my consent for my references to be contacted and for Sudbury District Restorative Justice to keep my information in their files.

Electronic Signature (Your full name and today's date DD-MM-YYYY)

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