The Cowichan Valley Emergency Program offers a wide variety of volunteer opportunities to help our communities. They can also help you gain valuable work experience, make use of your skills and knowledge, and meet new friends. Time commitment is flexible depending on the position. Although we have a list of identified needs, you may have a talent or ability that we haven’t included, so please list those below for our consideration.

Personal Information:

Last Name:*

Given Name(s):*

Name(s) You Go By:

Street Address:*

City:*

Postal Code:*

Mailing Address
(if different):

City:

Postal Code:

Primary Phone Number:*

Location:

Home Work

Cell

Secondary Phone Number:

Location:

Home Work

Cell

Date of Birth (optional):

Email Address:

Emergency Contact Information:

Last Name:

First Name:

Relationship to me:

Address:

City:

Primary Phone:

Secondary Phone:

Do you have a valid Driver's License?

Yes

No

Driver's Licence Class:

Languages spoken/written other than English (specify):

Skills or Experience:

Please select all that apply:*

Administrative Support Animal Care Emergency Communications Computer Skills Community Recovery Construction Emergency Social Services Emotional Support Fire Rescue First Aid

First Responder Food Services Labourer (heavy lifting) Personnel Management Search & Rescue Seniors / Diasbled Support Training / Instruction Transportation Volunteer Management

Disaster Related Training / Certification:

Please specify:

Possible Areas of Interest (please indicate your preference by selecting your first, second and/or third choice)

First Choice:*

Promote Emergency Preparedness Emergency Communications Search & Rescue Emergency Social Services Community Recovery Fire Rescue

Second Choice:

Promote Emergency Preparedness Emergency Communications Search & Rescue Emergency Social Services Community Recovery Fire Rescue

Third Choice:

Promote Emergency Preparedness Emergency Communications Search & Rescue Emergency Social Services Community Recovery Fire Rescue

Please indicate times you are available to volunteer (please check all that apply):

Weekdays:

Mornings Afternoons

Evenings Nights

Weekends:

Mornings Afternoons

Evenings Nights

Specific Days:

Monday Tuesday Wednesday Thursday

Friday Saturday Sunday

Anytime:

Yes

No

Are you available on short notice?*

Yes

No

Thank you for your interest! We look forward to meeting you!

During the interview, we will be asking you to complete and sign the Volunteer Application Form.