Miramichi Boys and Girls Club
Volunteer Application

Date Completed: 

Type of volunteer help preferred ( check all that apply ):

teaching an activity
assist with group
fundraising
supervising an activity
public relationship
administrative helper
maintenance
cleaning
driving
special events helper

Last Name: 
First Name: 

Mailing Address: 
Community: 

Postal Code: 
Telephone (h): 
Telephone (w): 

Email Address: 
Date of Birth: 

Work / Volunteer Experience: 

Name 2 people we may contact as reference:

1) 
phone: 

 2) 
phone: 

Please list some of your interests: 

Police Clearance: 

When are you available to volunteer? Please list day and time: 

What prompted you to consider our  
programs for volunteering? 

Permission for photo release

Completed By: 
Date: 

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