Step 1 of 4 25% Thank you for your interest in a volunteer position with the Learning Disabilities Association of Niagara Region (LDANR)! Please complete the questions outlined in this form. Once your form is received, a LDANR staff member will be in touch.Name* First Last Email* Phone*Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Date of Birth* Method of Transportation* Bus/City Transit Own vehicle Dropped off Availability*Please indicate the days and times during the week that you are available.Day of the weekTime How did you hear about the LDANR?* Flyer/Brochure Family/Friend LDANR Communication (email, website, etc.) Teacher/Professor In what capacity are you interested in volunteering? Check all that apply.* Programming Bingo Program VolunteerPlease note, all program volunteers working with children must have a current Police Vulnerable Sectors Clearance (PVSC) valid within one year prior to the start of the program. Upon request, if you do not currently possess a PVSC, LDANR office staff may provide you with a letter to present to your local police station to apply for the clearance. To apply, you must bring with you two pieces of government issued identification. If you are not a resident of Niagara, but have a temporary Niagara address, you must also bring with you proof of address (e.g., proof of lease, utility bill etc.). Please note: There is a small fee to obtain a volunteer PVSC. Click here for more information on applying for a vulnerable sectors check.Please indicate your preference of program:*For more information about each of these programs, visit the program pages on our website.Reading Rocks (One-to-one; Grades 2-10)JUMP Math (One-to-one; Grade 1-8)B.E.S.T. (Small group coping skills; Grade 3-5)C.H.A.M.P.S. (After-school homework help)S.L.A.M. Summer Camp (Full day; 6-11 yrs)Please indicate all programs of interest should your preference be full.* Reading Rocks (One-to-one; Grades 2-10) JUMP Math (One-to-one; Grades 1-8) B.E.S.T (Small group coping skills, Grades 3-5) C.H.A.M.P.S. (After-school homework help) S.L.A.M. Summer Camp (Full day; 6-11 yrs) Please indicate your location(s) of interest. Check all that apply.* Online St. Catharines Welland Beamsville Niagara Falls Port Colborne Fundraising/Event VolunteerThank you for your interest in supporting LDANR's fundraisers and events. The LDANR will reach out when these opportunities arise. As a non-profit organization, LDANR relies on Bingo funds to keep our program costs low. However, to receive these funds we must have two (2) volunteers attend each assigned Bingo session (1-2 per month). Please indicate below which Bingo sessions, if any, you would be interested/available to volunteer at: Niagara Falls (1-2 Wednesdays/year; 3:00-5:30 pm) St. Catharines (1-2 Sundays/year; 7:30-9:30 pm) Skills, Knowledge & ExperienceWhat is your educational background?Have you had previous experience as a volunteer? If so, with what organizations, and what kind of work did you do?Briefly describe your employment history.What are some of your strengths? What are some of your weaknessess?Is there any other information that you would like to provide?What do you hope to gain from being a volunteer with LDANR? ReferencesPlease provide the names and contact information for 2 references. Note: Family members cannot be used as references.Name of Reference #1 Relationship (i.e. supervisor, manager, etc.) Email PhoneName of Reference #2 Relationship (i.e. supervisor, manager, etc.) Email Phone Terms and Conditions* I hereby agree to comply with the Learning Disabilities Association of Niagara Region (LDANR)'s policy on violence and harassment. This is with the understanding that non-compliance may result in my removal from my LDANR volunteer position. I understand that the information collected on this form will only be used to assess my eligibility for the position. This information will only be shared with LDANR staff. I give permission to the LDANR to contact the persons listed as my references for the purpose of obtaining reference information. These persons are aware that the LDANR may contact them and have my permission to discuss information regarding my current and/or previous employment. I have read and agree to the above terms and conditions. Please type your name in the space below as your signature that you have read and agree to the above terms and conditions:* CAPTCHA
