London S Registry Week Volunteer Application

Solving Homelessness Together in London London’s Registry Week Volunteer Application

1. Volunteer Information First Name Last Name

Address

City Postal Code

Phone Email

2. Please mark each survey shift you are able to volunteer Early Morning Morning Afternoon Evening 7:00 am – 9:30 9:00 am – 12:00 pm 12:00 pm – 4:00 4:00 pm – 8:00 pm am pm

Tuesday, Oct 20 Not Available Orientation/Training Not Available Orientation/Training

Wednesday, Oct 21

Thursday, Oct 22

Friday, October 23 Not Available

3. Mandatory Volunteer Orientation and Training All volunteers must complete one orientation and training workshop. There are two session dates to choose from. Training is located at Registry Week Headquarters - Dundas Centre United Church, 482 Dundas St (Dundas and Maitland). Please check the session you plan to attend.

Tuesday, October 20, 2015 9:00am – 11:30pm (Dundas Centre United Church 482 Dundas St)

OR Tuesday, October 20, 2015 4:00pm – 6:30pm (Dundas Centre United Church 482 Dundas St.)

4. Applicant Signature

Thank you for your interest in volunteering during Registry Week. For more information please contact the City of London, Homeless Prevention Team at [email protected] or 519 661-2500 ext. 5729 www.london.ca Page 1 of 2 Solving Homelessness Together in London

- I am 18 years of age or older

- I would like to receive information about volunteering during the Point in Time Count (By February 29, 2016)

I understand that this is an application and that my participation in the events of London’s Registry Week is subject to selection through a screening process. I understand that confirmation that I have been accepted as a volunteer will be provided to me.

______Signature of Applicant

Please submit a completed copy of this form to: [email protected]

The personal information collected on this form is collected under the authority of the Municipal Act and will be used in reports to London City Council, interim and final result project reporting to the Canadian Alliance to End Homelessness, information releases to media including newspapers, radio and television, and updates to online websites including the City of London’s website, and social media including Facebook and Twitter. Questions about this collection should be addressed to the Manager of Records and Information Services at 300 Dufferin Ave., London ON N6A 4L9. Telephone: 519 661-2500 ext.5590

Thank you for your interest in volunteering during Registry Week. For more information please contact the City of London, Homeless Prevention Team at [email protected] or 519 661-2500 ext. 5729 www.london.ca Page 2 of 2