Student Volunteer Information This form is due by June 7th and is to be filled out by the student. Parents will be contacted by June 10th to confirm the student's acceptance to the LIT Summer Program. GENERAL Last Name: First Name: Initial: Street Address Apt.# P.O. Box City/Town Prov Postal Code Email Home Telephone No. Cell No. Emergency Contact Information Emergency Contact Relationship Home Telephone No. Business Telephone No. Email Address Education School and Grade Other Courses What experience do you have working with kids/youth? What gives you the desire to volunteer to work with kids? In the next year, what objectives (social, intellectual, physical) do you have for your personal life? PERSONAL INTERESTS, SKILLS AND ACTIVITIES Special Skills or Certifications: (i.e. tutor, lifeguard, second language, first aid) Interests, Hobbies, Sports Other Memberships/Volunteer Commitments: Do you attend church? If so, where? How long? Church Activities/Responsibilities if any: PERSONAL INFORMATION Please indicate what you believe to be your character strengths:CreativeTolerantListenerPatientSelf-DisciplineTrustworthyFlexibleLoyalFriendlySincereSensitiveHonestConscientiousPeaceableConfidentGrateful Have you ever worked with young people before?YesNo General Health: Allergies or Medication Conditions: Do you have a way of getting to programs in Bobcaygeon? If occasionally, please explain. Please Note: Subsides available, please contact Rebecca Sage directly to inquire. Payments may be made by cash, cheque or E-transfer. Please arrange to give cash or cheques to Rebecca Sage. Cheques should be made out to 'Youth Unlimited". If you wish to pay by E-transfer please send it to email@example.com with a note that it is for "Summer Camp Registration - Bobcaygeon." For more information please contact Rebecca Sage at firstname.lastname@example.org or 705-868-6898.