Community Council Declaration of Interest

This page is currently under review by Special Olympics Ontario

 

Community Council Declaration of Interest

Special Olympics Ontario – Declaration of Interest

Application for Community Council

Name: _________________________________________________________________

Address: _______________________________________________________________

Email: __________________________________________________________________

Telephone: (Home) ____________________________    (Work) _________________

Prefer to be contacted at:     Home: _______________    Work: __________________

Best time to call: ___________________

Position Applying for: ___________________________________________________

Have you ever been involved with Special Olympics Ontario? Yes ______ No_____

If yes, please list positions held: ____________________________________________

 

Please outline your other volunteer/work experiences relevant to the position applied for:

Organization            Position Held        Years of Service        Duties

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Briefly describe any other experiences/expertise you have:

Administration: __________________________________________________________

Leadership: _____________________________________________________________

Event Management: _____________________________________________________

Sport Specific: __________________________________________________________

 

Please explain why you would like to be part of the Special Olympics Ontario Team:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Would you be interested in any other positions within the organization? Administration (Chairperson, Treasurer, Volunteer Co-ordinator, Secretary) Sport (Head Coach, Assistant Coach, Manager)

________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

List name and phone number of two non family personal references:

Name: ______________________________________    Phone: _________________

Name: ______________________________________    Phone: _________________

 

PLEASE READ BEFORE SIGNING:

I understand that:

  • The information that I have provided may be verified, and I give permission to Special Olympics to make inquiries of others which may include a criminal background check to determine my suitability to act as a Special Olympics volunteer.
  • In the course of volunteering for Special Olympics, I may be dealing with confidential information and I agree to keep such information in the strictest confidence
  • The relationship between Special Olympics and volunteer is an “at will” arrangement and it may be terminated at any time without cause by either the volunteer or Special Olympics

 

I affirm that I have read the above and that the information that I have given is true and complete.

 

Signed: _______________________________________     Date: _________________