(this section is reserved for Professionals who wish to work with the participants).
Your Name (required)
Your Email (required)
Your Street Address (required)
City (required)
Province (required) QuebecOntarioAlbertaBritish ColumbiaManitobaNew BrunswickNova ScotiaNewfoundlandPrince Edward Island
Your Postal Code (required)
Your Phone number (required)
Languages Spoken EnglishFrenchOther
Languages Written EnglishFrenchOther
Are you currently in treatment for cancer or have a loved one currently in treatment? YesNo
Have you ever had cancer? YesNo
Have you ever been convicted of a crime? (NB a police check is required prior to being accepted as a volunteer) YesNo
List your present or past volunteer experiences:
Please indicate the service you wish to offer our participants:
What is your experience working with cancer patients?
How many years have you been working in this field?
Which training facility provided you your certification?
Do you have professional liability insurance? YesNo
(Please be prepared to bring a copy of your CV and proof of credentials to the interview)
Please check off your availability and be specific in the space provided (weekdays, evenings, one day, half day, etc.) weekdayseveningsweekendsOther
Please provide two references we may contact (name and phone number):
As a volunteer with WICWC, we would expect you to be comfortable with and adhere to our core values as part of your role in representing WICWC and the people we serve.
WICWC promotes wellness and the following core values: Respect for people of all ages, races, cultures, and sexual preferences. We are completely non-judgemental and we are a team.
Please let us know you're human.
