COVID Changemaker

You can become a COVID Community Changemaker!

In response to the needs of our community, we are assembling a team of changemakers. Individuals who want to volunteer to help those affected by COVID-19.

How could you volunteer?

COVID-19 Virtual Volunteering

refers to volunteering that can be performed without any contact, such as telephone outreach to vulnerable individuals, information dissemination etc.

COVID-19 Light Touch Volunteering

refers to volunteering that can be performed with minimal contact, such as pick up and delivery services for vulnerable individuals.

COVID-19 High Touch volunteering

refers to volunteering that must be performed with increased contact, such as passenger transportation to appointments & volunteer support essential services.

Your community needs you. Want to help?

By filling out this form, you are expressing your wish to become a COVID Community Changemaker.

1Contact Information

2Goals & Objectives

3Experience

4References

5Security Check

6Availability

7Consent

Contact Information
Name*
First Last
Email*
Phone*
Address*
Street Address Address Line 2 City Postal Code

Goals & Objectives
How would you like to be a COVID Community Changemaker?*
- Select All
- COVID-19 Virtual Volunteering
- COVID-19 Light Touch Volunteering
- COVID-19 High Touch Volunteering
Help us make your match. How do you identify?*
What accommodations might be needed to support your volunteer experience?
Please tell us how you would like to contribute including any specific skills

Experience
Previous Volunteer Experience
Organization Volunteer Role Start Date End Date
Other relevant experience

References
Primary Reference Name*
First Last
Primary Reference Relationship*
Primary Reference Email*
Primary Reference Phone*
Primary Reference Address*
Street Address Address Line 2 City Postal Code

Security Check
Have you received a Police Record Check?*
Date of most recent Police Record Check*
MM slash DD slash YYYY
Have you ever received a Vulnerable Sector Check?*

Availability
When are you available*
Time you are willing to commit
How did you hear about PIN?

Consent
Email Consent
Do you consent to receive email communications from us?
Information Consent
I consent to being contacted by PIN - COVID organizations.
Email
This field is for validation purposes and should be left unchanged.

COVID Changemaker

You can become a COVID Community Changemaker!

How could you volunteer?

COVID-19 Virtual Volunteering

COVID-19 Light Touch Volunteering

COVID-19 High Touch volunteering

Your community needs you. Want to help?

Contact Information

Goals & Objectives

Experience

References

Security Check

Availability

Consent

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Organization	Volunteer Role	Start Date	End Date