Volunteer Work

Citizens / Recreation and Community Life / Volunteer Work

Become a volunteer in my community

Why volunteer?

To :

Express your interest in a cause

Be part of those who work to make things better

Help others and contribute to the well-being of the community

Make a difference

Be part of a positive change in your community

For more information, Je Bénévole.ca.

If you got to this point, it is because you care about your community and want to volunteer. We invite you to fill out and submit the form below. Your form will then be shared with the various organizations within the municipality.

Volunteer Application Form

Sex

Man Woman

Language spoken

French English

Date of birth

First name

Last name

Home phone

Cellular phone

Address

Postal code

Places where you would like to volunteer: Check one or more of the following.

Breckenridge and Luskville areas
Quyon area
Other nearby municipalities

Person to contact in case of emergency

a. First name

b. Last name

c. Telephone

Do you have a valid Quebec driver's license?

Yes No

Which of the following types of activity are you interested in getting involved in? Check one or more answers

Reception (orienting people, providing general information)
Food (food distribution, meals on wheels)
Volunteer escort (transporting people and/or equipment from one place to another)
Effectuer des appels de sécurité (s’assurer que les personnes isolées vont bien)
Any other volunteer need

Check the appropriate boxes below. (The purpose of this question is to give us an idea of your availability. If you are available less than half a day; we will confirm this with you at a later date).

Day	Morning	Afternoon	Evening
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Have you had a criminal record check in the last five (5) years?

Yes No

By answering yes to the next question, you certify that you have no criminal or judicial record.

Yes No

Have you traveled in the last 14 days or been in contact with someone who has traveled in the last 14 days?

Yes No

I agree to have my contact information shared with organizations in my area.

Yes No