Note: If you prefer to download a fillable PDF form, please visit our Contact page. Volunteer Registration Form Date MM slash DD slash YYYY Name* First Last Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Best Number to Reach You*Email* Emergency Contact* StatisticsAge* Under 19 19-35 36-50 51-65 Over 65 Gender* Male Female Employment Status* Unemployed Student Homemaker Retired Self-employed Employed Full-Time Employed Part-Time How did you hear about Langley Volunteer Bureau?* community services phone book radio/tv word of mouth poster/brochure newspaper website other: What Type of Volunteer Work Interests You?Describe any previous volunteer/work experience.What is your availability? Weekdays Evenings Weekends Only Are there any groups you would NOT feel comfortable working with?Do you have a valid Drivers License? Yes No Someone will contact you to confirm receipt of your application. In the meantime, if you have any questions, please feel free to contact us for more information.Some volunteer positions require successful completion of a criminal record check before an assignment is verified. Please discuss this with your interviewer if you have any concerns.