Community Care

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  11. (valid email required)
  12. Salutation
In Case of Emergency Contact:
  1. Emergency Contact One
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  7. Emergency Contact Two
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  1. Which Service(s) or Area(s) of Community Care Are You Interested in Helping With?
  4. Season Preferred
  6. Days Preferred
  8. Time of Day Preference
  1. If you drive for Community Care the following information is required:
  1. Would you share with us briefly your background, employment, community, and/or previous volunteering experience? This information will give CCCKL the opportunity to fully utilize your talents and past experiences within our organization.
  1. Please list two references (not family members) who will be contacted for further information.
  2. Reference One
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  9. Reference Two
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  1. COMMUNITY CARE CITY OF KAWARTHA LAKES STATEMENT OF CONFIDENTIALITY
  2. I understand that I will be privileged to information about clients, families and operations of COMMUNITY CARE CITY OF KAWARTHA LAKES. I understand that much of this information is private and confidential and that I agree to treat all such information as confidential.
  3. I agree not to disclose information shared with me through COMMUNITY CARE involvement, without receiving consent of the client and approval by the President/Chairperson, or staff designate. I understand that this includes disclosing information to relatives, friends, and in most situations to members of my own family. I understand this responsibility extends beyond my involvement with Community Care.
  4. I understand that if it is felt that there has been a breach of confidentiality, the appropriate authority will bring it to my attention.
  5. I am fully aware that in order for the Agency to comply with provincial regulations the Agency may be required to obtain a police check and/or reference checks. I give permission to Community Care City of Kawartha Lakes to perform reference checks and police reference checks.
 

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