Volunteer Board of Directors Application

The program is governed by an elected board of directors. The unit has 8-10 directors, 1-2 police liaison members on the board, 2 staff members and approximately 25 volunteer advocates.

To apply for a position on the board of directors please fill out the form below.

Personal Information
Name (First, Middle, Last)
Maiden Name
Date of Birth (YYYY / MM / DD)
Full Mailing Address
Street Address (if different)
Home Phone
Work Phone
Cell Phone
Email
Driver's License Number
References May include employers, volunteer supervisors, friends, co-workers and relatives. Please provide at least three references. Inability to contact references may preclude you from successfully completing the application process. Please include your affiliation or relationship to each reference.
Name
Address
Day Phone
Relationship
Name
Address
Day Phone
Relationship
Name
Address
Day Phone
Relationship
Detailed Information
Education Qualifications
Why do you want to be a volunteer ?
Why do you want to be a Victim Services Board Member? What skills do you bring?
How did you hear about Victim Services?
Please list organizations and associations you are currently involved with:
Are you legally entitled to work in Canada?	Yes No
Have you ever been convicted of an offence in violation of the Criminal code of Canada for which you have not been pardoned?	Yes No
Is there any additional information you would like to tell us?
I hereby give permission to the Royal Canadian Mounted Police and Wetaskiwin and District Victim Services Society to conduct a criminal records check, driver’s abstract check and RCMP Enhanced Security Check. I understand these checks cannot be conducted against my will, and I also grant permission to provide information such as maiden name, previous addresses, and other information for the sole purpose of the criminal history check. I also understand that this is only for background screening for Volunteer Advocate applicants, and will not be used or disseminated outside these boundaries. Should the enhanced security check disclose that I have been convicted of criminal offenses within the Criminal Code of Canada for which I have not received a pardon, my application will not be processed any further, or if my driving abstract should not be clear I may not be processed further.
I accept and agree with the statement above	Yes No

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