PROTECTED WHEN COMPLETED

Volunteer Application Form Summer 2012

SECTION 1 APPLICANT INFORMATION
NEW VOLUNTEER RETURNING VOLUNTEER FIRST NAME
s

MALE FEMALE LAST NAME

DATE OF BIRTH (MM/DD/YYYY)

11/30/1996

Jeff

Zhang
POSTAL CODE

ADDRESS

125 Bren Maur Road

PROVINCE

CITY

Ottawa
6138431888

Ontario

K2J0X6
6139790198

TELEPHONE NUMBER (HOME)

TELEPHONE NUMBER (WORK)

TELEPHONE NUMBER (CELL)

EMAIL ADDRESS

jeff2007go@hotmail.com

EMERGENCY CONTACT

Charlie Zhang
s

TELEPHONE NUMBER

6138431888
OTHER (SPECIFY) _____________________________ s SPOKEN WRITTEN

LANGUAGES
s

ENGLISH s SPOKEN s WRITTEN

FRENCH s SPOKEN s WRITTEN

Mandarin

CORRESPONDENCE
s

ENGLISH FRENCH

DO YOU HAVE ANY PHYSICAL OR OTHER NEEDS THAT SHOULD BE TAKEN INTO CONSIDERATION? YES

NO

IF YES, PLEASE SPECIFY BELOW

Your voluntary response to the questions below will assist us in determining whether the National Capital Commission (NCC) Volunteer Centre is becoming a more diverse place. WHAT IS YOUR COUNTRY OF BIRTH? WHEN DID YOU ARRIVE IN CANADA?

China

2000

SECTION 2 RELEASE OF LIABILITY AND PERMISSION REGARDING PICTURES

SCREENING PROCESS The NCC complies with the provisions of the government security policy in relation to security clearances. On behalf of the departmental security officer, the NCCs Security Service must conduct an initial criminal records check for all volunteers over the age of 16. Fingerprint identification may also be required. UNDERTAKING TO ACT IN A RESPONSIBLE AND SAFE MANNER In accordance with the current Code of Conduct, I hereby undertake and agree to act in a responsible and safe manner at all times, while acting as an NCC volunteer. INSURANCE The NCC maintains insurance to the benefit of its volunteers while they are acting as such. This insurance coverage is for claims arising out of injuries to third parties which are caused by the negligence of the volunteer and for accidental death or dismemberment of a volunteer that occurs in the course of NCC volunteer activities. PERMISSION TO USE PICTURES I hereby grant to the NCC and persons acting on its behalf the unrestricted and perpetual right and permission, in respect of pictures or film footage that it, through its photographers and/or contractors, has taken of me or in which I may be included with others, to use, to publish, to broadcast and to authorize a third party to use, publish or broadcast the same in whole or in part, in any and all media now or hereafter known, for the purpose of promoting volunteerism, the NCC, the capital and/or Canada.
s

I acknowledge that I have read and understood the above.

x APPLICANT SIGNATURE
Page 1 of 2

x PARENT/GUARDIAN SIGNATURE (IF VOLUNTEER IS UNDER AGE 18) DATE

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NCC-CCN | 40 Elgin Street, Ottawa Ontario K1P 1C7 | www.canadascapital.gc.ca

SECTION 3 - VOLUNTEERING OPPORTUNITIES

Important for volunteer opportunities! Please number your choices in order of preference (1, 2, 3, etc.) so that we can offer you your second choice, in the event that your first choice is not available.
1

ACTIVITY 1. CANADA DAY (JULY 1, 2012) PARLIAMENT HILL

___ Logistics ___ Information officer (must be bilingual: English and French) ___ Distribution ___ Host(ess) ___ Crowd control ___ Green Team ___ No preference

MAJORS HILL PARK

___ Logistics ___ Information officer (must be bilingual: English and French) ___ Distribution ___ Host(ess) ___ Crowd control ___ Activity assistant ___ Chicken tent ___ Green Team ___ No preference

JACQUES-CARTIER PARK
___ Logistics ___ Information officer (must be bilingual: English and French) ___ Distribution ___ Host(ess) ___ Crowd control ___ Activity assistant ___ Green Team ___ No preference

Large T-Shirt Size Specify: ______________________

Please check off the activities you would prefer.

ACTIVITY 2. MAPLELAWN GARDEN (APRIL TO OCTOBER)

___ Gardener Perform general flower-gardening duties (weeding, Gardener planting, etc.).

ACTIVITY 3. MACKENZIE KING ESTATE (JUNE TO SEPTEMBER)

___ Guide-interpreter Dress in period costume, meet and interact with visitors, provide guided tours of the garden. Requirements: Must have own means of transportation; must possess interpersonal communication skills (bilingualism and experience in giving public presentations would be assets).

ACTIVITY 4. GATINEAU PARK (MID-AUGUST TO THE END OF OCTOBER)

___ ___ Foot patrol Mountain bike patrol Requirements: Must have taken a first aid course; must be bilingual; must be at least 18 years of age.

ACTIVITY 5. NEWSLETTER
___ Write articles for the volunteer newsletter. ___ Reporter (NEW!)

COMMENTS

SECTION 4 CONTACT US
Please complete and return by mail or fax: Mail: National Capital Commission Volunteer Centre 20240 Elgin Street Ottawa ON K1P 1C7 Fax: 613-239-5133 For current information on volunteer positions, visit our website, call us or send us an email. Telephone: 613-239-5373 Email: volunteer_benevoles@ncc-ccn.ca Website: www.canadascapital.gc.ca/volunteer

Privacy Statement The personal information that you provide will only be used by the NCC to select and contact volunteers for suitable placement in support of NCC projects, events and other NCC activities. The information is protected under the Privacy Act. The information will be retained in the files of the NCC under the standard program records Information and Orientation" (Record Number: CECM-M400), "Volunteer Data Bank" (Specific Bank Number: PPU 070). You have the right to review and correct information about yourself and can be assured that it will not be used for unauthorized purposes. NCC-CCN | 40 Elgin Street, Ottawa Ontario K1P 1C7 | www.canadascapital.gc.ca Page 2 of 2
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