Volunteer Application - Options for Sexual Health

Name*

First Last

Address*

Street Address Address Line 2 City Postal Code

Email*

Telephone (home)*

Telephone (work)

Age (if under 19)

Languages spoken

Please list all languages you speak fluently

Which volunteer roles do you prefer?*

Please check all you are interested in.

Clinic
Community Relations
Other

If you are interested in working in a clinic, please select the clinic locations where you would like to work. First choice:*

Second Clinic Location choice:*

Postsecondary Education/Training

Please list the highest level of education achieved.

Work or Volunteer Experience (previous volunteer experience preferred):*

Please give a brief description of work experience that you would consider to be relevant to the work of Options for Sexual Health.

How did you learn about our volunteer program?

Friend
Relative
Website
Clinic
Poster
Other

What do you hope/expect a volunteer experience with us will offer you?*

With all the non-profit organizations that need help, what interests you about volunteering in the field of reproductive and sexual health with Options for Sexual Health?*

Respecting the boundaries and confidentiality of our clients is important. What does confidentiality mean to you?*

How do you maintain a nonjudgmental attitude towards others?*

One goal of Options for Sexual Health is to empower individuals to make informed decisions about their reproductive and sexual health. What does empowerment mean to you?*

Please comment on what "choice" means to you:*

Describe how you handled an experience where your beliefs differed strongly from someone else.*

Many people you will come in contact with at Options for Sexual Health will have different beliefs and behaviours from you, but still require unbiased, accurate information.

Anything else you would like to share with us?

I agree to...*

Honour the mission of Options for Sexual HealthTo champion and celebrate the sexual health of all people in BC by supporting, providing, and promoting inclusive and accessible health care and education; or more succinctly: To champion and celebrate sexual health?
Support reproductive choice for all British Columbians, including abstinence, pregnancy, abortion, and the prevention of sexually transmitted infections and unintended pregnancy?
Support the provision of contraceptive education and products to sexually active minors?
Keep confidentiality regarding all Options for Sexual Health's client, volunteer, and paid staff information?
Be responsible in your own learning by attending initial and ongoing education and training?

To work with Options for Sexual Health, all volunteers must agree to the above statements.

I am able make a one-year volunteer commitment with Options for Sexual Health*

Yes
No

Reference (name)*

Please provide a reference (other than family or friends) from someone who has known you for at least one year and can give an objective assessment of your suitability for involvement as a volunteer with Options for Sexual Health. The ideal reference would be from a previous volunteer experience.

First Last

Reference (email)*

Reference (phone)*

Relationship to you:*