Volunteer - Manitoba Islamic Association

Areas of Interest (check all that apply) *

Other area of interest

Name *

First

Last

Email *

Date of Birth *

Phone # *

Hours available per week *

Do you have your own transportation? *

Do you have a driver's license? *

Please list at least 2 references

Ref 1 Name *

Ref 1 Organization/Position *

Ref 1 Phone *

Ref 2 Name

Ref 2 Organization/Position

Ref 2 Phone

Any additional comments

DECLARATION and AUTHORIZATION *

I hereby declare that the information provided in this form is true and complete to my knowledge. I understand that a false statement may disqualify my application or cause my dismissal. I have not had any accusations of misconduct against me and there is none known to me that could prevent me from doing the applied for work. I authorize the Manitoba Islamic Association to contact any person listed as a reference in this or the attached document I have provided.

Application Form