Date of Application:   ___________________________

Name:

Last   ________________   First   ________________  Middle   ________________

Street Address   __________________________________

Province   _______________   Postal Code   _______________

Telephone:

Residence  ____________________   Business/Work  ____________________

Fax  ____________________   Email  __________________________________

If we are unable to place you in a volunteer position in the near future, how long would you like us to keep this application on file?

1 Month ___     3 Months ___     6 Months ___     1 Year ___     

1. In what capacity would you like to volunteer?

   _____ AIDS Awareness Week							_____ World AIDS Day
   _____ AIDS Walk for Life							_____ Community Outreach
   _____ Board Member							_____ Ticket Selling
   _____ Poster Making							_____ Preparing Ribbons
   _____ Setting up displays							_____ Public Relations
   _____ Clerical

2. AVAILABILITY:
   When are you available to volunteer ?     Specify what day(s) and a time frame.
   

   DAY:							TIME:
   _____ Monday							_____ Morning
   _____ Tuesday							_____ Afternoon
   _____ Wednesday							_____ Evening
   _____ Thursday
   _____ Friday
   _____ Saturday
   _____ Sunday

3. List specific hours if necessary:
   

   ________________________________________________________________

   ________________________________________________________________

   ________________________________________________________________

4. Please describe related work experience:
   

   ________________________________________________________________

   ________________________________________________________________

   ________________________________________________________________

   ________________________________________________________________

   ________________________________________________________________

   ________________________________________________________________

   ________________________________________________________________

   ________________________________________________________________

   ________________________________________________________________

   ________________________________________________________________

   ________________________________________________________________

   ________________________________________________________________

   Please print and mail your completed Volunteer Application Form to:

   ACWN
   AIDS Committee of Western Newfoundland, Inc.
   P.O. Box 303
   Corner Brook, NF    A2H 6C9