Volunteer Application

Thank you for applying to be a volunteer with Ascentria.

All new applicants in a recurring role and over the age of 18 years must complete the application below which includes:

  • Confidentiality agreement
  • Reference check

In addition all volunteers will be required to complete a:

  • Criminal background check
  • Any other applicable checks required by Ascentria Care Alliance

Insurance verification if transporting clients in your personal vehicle is mandatory. Some programs may have additional requirements for volunteers.

Volunteer Personal Contact Informationid366197922
Emergency Contact Informationid16185077
Employment Historyid-1883515176
Do you have any relatives working at Ascentria?:
Previous Volunteer Experienceid-1676374221
Do you have previous volunteer experience?:
Reference Check Release - Authorization for Reference Release. We prefer (2) professional references if you have work and/or volunteer experience. If you do not have experience, please provide us with (2) personal references. At least two references are required.id198052502
Drivers Vehicle Insuranceid281458839
Will driving be one of your responsibilities as a volunteer for Ascentria?:
Volunteer Responsibilities and Confidentiality Agreement - Please read and sign below
All Media Consent – Signing this consent is optional
Ascentria may use my: