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Name
*
First
Last
Address
*
Street Address
City
Postal Code
Telephone
*
Email
*
Education
High School
University/College
Volunteer Experience
Employment Experience
Describe any skills, experiences or training that you feel may be an asset to the Kenora District Homes Volunteer Program?
Health
Excellent
Good
Do you have any physical limitations
Yes
No
Please explain
Do you speak a second language?
Yes
No
What language?
Volunteer Activity preference
Do you wish to have:
Patient Contact
Little or None
No Preference
Time and Day of preference:
Monday
Morning
Afternoon
Evening
Tuesday
Morning
Afternoon
Evening
Wednesday
Morning
Afternoon
Evening
Thursday
Morning
Afternoon
Evening
Friday
Morning
Afternoon
Evening
Saturday
Morning
Afternoon
Evening
Sunday
Morning
Afternoon
Evening
References who may be contacted:
Name
Home Address
Telephone
I, HEREBY, AGREE TO RESPECT THE CONFIDENTIALITY OF ALL INFORMATION THAT I MAY RECEIVE REGARDING RESIDENTS OR STAFF WHILE A VOLUNTEER AT ONE OF THE THREE DISTRICT OF KENORA HOMES FOR THE AGED (PINECREST HOME, NORTHWOOD LODGE, OR PRINCESS COURT).
Home
Long Term Care
Admission Process
Northwest LHIN
Admission FAQ’s
Regulations
About Us
Our Commitment
Accommodations
Our Team
Resident & Family Councils
Auxiliary
Book a Tour
Service
Personal Care Services
Specialized Services
Resident Programs
Dietary Services
Community Support Services
Helping You
Frequently Asked Questions
Links
Join the Team
Invitation
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Contact
Submit an Inquiry
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