Volunteer Application Form

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Adsum for Women & Children

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Thank you for your interest in volunteering! Please complete the form below and an Adsum team member will contact you.

Questions? Please call 902.423.5049 or email adsum@adsumforwomen.org.

Contact Information

Name *

First Name

Last Name

Email Address *

Cell Phone *

(###)

###

####

Home Phone

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you have a recent Criminal Record Check?

Yes

Do you have a recent Child Abuse Registry Check letter?

Yes

Employer

How did you hear about Adsum?

Volunteer Information

Why would you like to volunteer with us? *

Experience.

Please list any relevant volunteer, work, or life experience that you have.

Language(s) Spoken *

English

French

Arabic

Chinese

Spanish

German

Spanish

Other

Availability *

Volunteers typically work a 2 hour shift per week between the hours of 9:00 am and 8:00 pm.

Sunday - morning

Sunday - afternoon

Sunday - evening

Monday - morning

Monday - afternoon

Monday - evening

Tuesday - morning

Tuesday - evening

Wednesday - morning

Wednesday - afternoon

Wednesday - evening

Thursday - morning

Thursday - afternoon

Thursday - evening

Friday - morning

Friday - afternoon

Friday - evening

Saturday - morning

Saturday - afternoon

Saturday - evening

I am over the age of 15.

Yes

Emergency Contact

Emergency Contact Name

First Name

Last Name

Emergency Contact Relationship

Emergency Contact Phone

(###)

###

####

References

Please do not include relatives.

Reference 1

First Name

Last Name

Reference 1 Organization

Reference 1 Phone

(###)

###

####

Reference 1 Email

Reference 1 Relationship to You

Thank you for your interest in being a part of the Adsum volunteer team! We look forward to working with you. You will be contacted to arrange a Volunteer Orientation. Please bring along a driver's license or other form of ID and current Criminal Record Check and Child Abuse Registry Letter if you have them.

Thank you!

Adsum for Women and Children, our housing, programs, and services are located and provided in Mi'kmaw Territory. We strive for meaningful partnerships with all the peoples of this land as we continue to live and learn in Kjipuktuk (Halifax). Through the Peace and Friendship Treaties, which the Mi’kmaq, Wolastoqiyik, and Passamaquoddy Peoples first signed with the British Crown in 1725-1726, there was no surrender of lands nor resources. When Mi'kmaq agreed to the Peace and Friendship Treaties with the British, they were extending an offer to live in Mi'kma'ki as part of msit no'kmaq (all my relations). Through this invitation to a Treaty relationship, they sought to live in peace and friendship. Agreements within these Treaties outline a path for the ongoing relationship between Nations in mutual respect.

2421 Brunswick St
Halifax, NS B3K 2Z4

(902) 423-5049
adsum@adsumforwomen.org

Canada Revenue Agency Charitable Registration Number: 13 225 70 31 RR0001

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