First Name: *

Last Name: *

Address 1: *

Address 2:

City: *

Province:

Postal Code:

Daytime Phone Number: *

Evening Phone Number: *

Cell Phone Number:

Contact Time:
What is the best time to contact you?
Daytime Evening

Email Address: *

Date of Birth: *
Make sure you enter date in correct format YYYY-MM-DD
YYYY-MM-DD Select Date

Emergency Contact: *

Emergency Contact Phone: *

Vest Size:
Mens-xxl Mens-xl Mens-lg Mens-med Mens-small Ladies-xl Ladies-lg Ladies-med Ladies-small Ladies-xs

Past Volunteer Experiences & References

Please provide name and phone number. A minumum of two references will be contacted:

Experience/Reference #1

Experience/Reference #2

Experience/Reference #3

Recruited by:
Dr Bob Steadward – CCMA Edmonton Co-Chair Dave Majeski – CCMA Edmonton Co-Chair Jackie Rae Greening – CCMA Edmonton Honorary Chair Chris Sheetz – CCMA Edmonton Honorary Chair Eleanor Fulton – Vice Chair, Volunteers JoAnn Kirkland – Vice Chair, Hosting Danielle L’Hirondelle – Vice Chair, Marketing Deb McCurdy – Vice Chair, Marketing Chris Moore – Chair, Operations Colette Ries – Vice Chair, Volunteers Ingrid Roffel – Vice Chair, Public Events Yvonne Roffel – Vice Chair, Conference Events Rob Tanner – Vice Chair, Hosting CCMA Office or Executive Global Country Other

If Other:

Area of Interest

Choose three in order of preference.

#1 Choice:
Drivers Registration Desk Greeter Office Assistant Hotel Information Ambassador Room Monitor Conference Reception / Gala / Brunch Event Volunteer First Aid / Security Awards Night Seat Filler

#2 Choice:
Drivers Registration Desk Greeter Office Assistant Hotel Information Ambassador Room Monitor Conference Reception / Gala / Brunch Event Volunteer First Aid / Security Awards Night Seat Filler

#3 Choice:
Drivers Registration Desk Greeter Office Assistant Hotel Information Ambassador Room Monitor Conference Reception / Gala / Brunch Event Volunteer First Aid / Security Awards Night Seat Filler

Other Information:
include event requests, additional comments / information, availability or physical conditions which may restrict your ability to volunteer