Name *

First Name

Last Name

I will commit to praying for Toronto City Mission on a regular basis *

Yes

I would like to be added to the monthly newsletter with prayer points

Yes

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

I am interested in the following programs: *

KIC (Kids in Community)

EPIC (Education Provided in Community)

RMM (Role Model Moms) Victoria Village and Jane-Finch sites only

Youth Extreme

I would like to volunteer at the following site(s) *

Check all that apply

Flemingdon Park

Kingston - Galloway

St. James Town

Willowtree

Role Model Mom

Office

Other

Have you ever been convicted of a criminal offence for which a pardon has not been granted? *

Yes

No

* *

I hereby certify that the facts given on this application are true and complete to the best of my knowledge. I understand that if I am accepted as a volunteer and portions of this application are found to be false, it is sufficient cause for my dismissal. I understand that to become a volunteer at Toronto City Mission will require a personal interview, good references, and some positions may require a clean police reference check and/or a signed statement of faith.