Volunteer Application FormFirst Name(Required)Last Name(Required)Date of Birth DD slash MM slash YYYY Status in CanadaPermanent ResidentPR - Live-In CaregiverCUAET Visa HolderConvention RefugeePrivate Sponsored Refugees (PSR)Study Permit (International Post-Secondary)Study Permit (Other)Work Permit (PGWP)Work Permit (Open)Work Permit (Closed)Canadian Citizen (By Birth)Canadian Citizen (Naturalized)Refugee Claimant (RC)Asylum SeekerVisitor - Temporary Resident VisaSex at BirthMaleFemaleXDo you identify as 2SLGBTQI+?YesNoGenderFemaleMaleNon-Binary/Gender-neutralPrefer no to answerMy identity is not listedIf other, please specifyLanguages spokenEnglishFrenchAffarArabicChineseFarsi (Persian)KoreanMandarinTagalogAcholiAdaAfghanAfrikaansAkaAkanAklanonAkraAlbanianAmerican Sign Language (ASL)AmharicAnuak (Anywa)AranArmenianAshantiAssameseAssyrianAzeriBahasa IndonesianBalochiBambaraBamileke / GhomalaBansoBantuBauleBelarusianBelenBembaBembeBengaliBeniBeninBerberBetiBhariBicol/Bikol/BicolanoBijaiyaBilenBiniBisayaBissaBontokBraille (translation only)BretonBulgarianBurji / Bembala / Bambala / DaashiBurmeseBusanBusangoCantoneseCatalanCebuanoChakmaChaldeanChaochoChavacanoChichewaChinChinese - Simplified (TRANSLATION ONLY)Chinese - Traditional (TRANSLATION ONLY)ChiuchowChiyaoChowchauConcaniCreeCreoleCroatianCzechDagaareDanishDariDaza / Dazaga / TebuDinkaDioulaDutchDzongkhaEdoEfikEsanEstonianEweFangFantiFe'fe / Fe'efe'e / Nufi / BafangFilipinoFinnishFlemishFoochowFoukiFoullahFukineseFulaniGaGaelicGeorgianGermanGrebo/KrumenGreekGuerzeGujaratiHainamHakha ChinHakkaHararaHararyHargarHassanyaHausaHebrewHiligaynonHindiHindkoHokkinHungarianIbibioIboIcelandicIdomaIgboIgorotIjawIkaIlicanIlocanoIlongoIndonesianIshanItalianItsekiriIvbiosakonIziJapaneseJaraiJavaneseJingpoJolayJuba ArabicKacchiKakwaKanareseKandahariKankaniKannadaKapampanganKarenKashmiriKazakhKenyang / Nyang / Banyang / ManyangKhmerKifuliruKihavuKihemba/Hemba/Kiluba-HembaKikambaKikongoKinnauriKinyamulengeKinyarwandaKiregaKirundiKiswahiliKitubaKonkaniKpelleKrioKurdishKurmanjiKyrgyzLa langue des signes québécoise (LSQ)LaotianLariLatvianLebaneseLengieLingalaLithuanianLowmaLugandaLugishuLutoroMabanMacedonianMacenaMacuaMahouMakondeMalagasyMalayMalayalamMaligoMalinkeMalteseMandeMandingoMarathiMasalitMashiMendeMinaMizoMoldovanMongolianMooreNaandi/CemualNdebeleNepaliNgiemboonNgombaNorwegianNubianNuerNzimaOkoOkpeOriyaOromoOsalOther African LanguagesOther Chinese DialectsOther European LanguagesOther LanguagesOther Middle Eastern LanguagesOther Signed LanguagesOther South Asian LanguagesOther South East Asian Lang.OtuhoPahariPampangoPangasinanPashtoPeulPhuockienPidginPlautdietschPolishPortuguesePoularPunjabiRohingyaRomaniRomanianRukigaRunyankoleRussianRutooroSahoSamoanSangoSanskritSaraScoulaSechuanSenufoSerbianSerbo-CroatianSesothoSeswiSeychellesShanShanghaiShansaiShillukShonaSign LanguageSindhiSinhaleseSlovakSloveneSomaliSonghaiSoninkeSoraniSothoSoussouSouthern BurunSpanishSuesueSukumaSwahiliSwazaiSwedishSwiss GermanTaichewTamasheqTamilTariTatarTatshaneseTeluguTemneTeochewThaiTibetanTichiewTigreTigrignaTiminiTivToishanTshilubaTsibulaTurkishTwiUdukUhroboUigrigmaUkrainianUmbunduUnamaUnknownUrduUyghurUzbekVietnameseVisayanWarayWelshWestern Hemisphere Indian LangWolofXhosaYacoubaYako/Loko/LokaaYekhee/Afenmai/AfemaiYiboeYiddishYorubaZandeZshilubaZugandaZuluEthnic/Cultural IdentitiesEast Asian (e.g., Chinese, Taiwanese, Japanese, Korean, etc.)Latino/x/a, South, Central American or CaribbeanPerson of African ancestry (Black)Person of European ancestry (White)South Asian (e.g., Bangladeshi, Pakistani, Indian, Sri Lankan, etc.)Southeast Asian (e.g., Vietnamese, Thai, Cambodian, Malaysian, Filipino/x/a, etc.)West Asian or Arab (e.g., Iranian, Afghan, Lebanese, Egyptian, Iraqi, Armenian, etc.)Prefer not to answerAn identity not listed (please specify, for example, from a Diasporic CommunityIf other, please specifyEmail(Required) Cell Phone(Required)Home PhoneAddress(Required)City(Required)CityVictoriaBrentwood BayCentral SaanichColwoodEsquimaltHighlandsJames BayLangfordMetchosinMayne IslandNorth Pender IslandNorth SaanichOak BayPortage InletSaanichSaanichtonSidneySookeView RoyalSalt Spring IslandMalahatMill BayShawnigan LakeProvince(Required)British ColumbiaPostal Code(Required)Work Experience (Please indicate experience in any of the occupational areas (Select all that apply))Accounting/BookkeepingAdministrationAgricultureArchitectureArts/Culture/RecreationBusiness/FinanceCustomer Service/TourismEducationEngineeringGovernment/Community ServicesHealthcareHuman ResourcesInformation TechnologyLegal ServicesManufacturingSales/MarketingScience/ResearchTrades/TransportEmployer (If applicable)Education LevelHigh School or LowerPre-university/Post SecondaryCertificate/Diploma/ApprenticeshipBachelor DegreeMaster DegreePh.D.I am currently enrolled in an academic/education degree programYesNoI am a high school studentYesNoI am a high school studentYesNoVolunteer ProgramPlease tell us why you are interested in volunteering with ICAHave you worked with immigrants and/or refugees previously?YesNoVolunteer Position(s) Interested In(Required) Anti-racism Program Assistant Career Mentor Community Connections Community Engagement Volunteer Conversation Circle Volunteer English Class Teacher's Assistant Immigrant Support Group Income Tax Photographer or Videographer Special Event Assistant Refugee Support Volunteer Youth Programs Volunteer Skills/Qualifications(Required) Accounting/Bookkeeping Administrative/Office Arts & Crafts ESL Facilitation/Training Income Tax Mentoring/Coaching Photography Teaching/Tutoring Video/Filmmaking Web/Social Media Writing Youth Programming Any other skills, hobbies, interests you would like to add?AvailabilityMonday Morning Afternoon Evening Tuesday Morning Afternoon Evening Wednesday Morning Afternoon Evening Thursday Morning Afternoon Evening Friday Morning Afternoon Evening Saturday Morning Afternoon Evening Sunday Morning Afternoon Evening Availability NotesPlease provide details of someone we can contact in case of an emergencyEmergency Contact Name(Required)Relationship(Required)FatherFriendOther RelativesSpouseChildSponsorSiblingContact Phone(Required)Please provide 2 references.(Please inform your references they will be contacted.)Reference Name(Required)Contact PhoneContact's Email(Required) Reference Name(Required)Contact PhoneContact's Email(Required) Please upload a copy of your ID for the Criminal Record Check.(Required)File(Required) Drop files here or Select files Accepted file types: jpg, gif, png, jpeg, pdf, tiff, Max. file size: 10 MB, Max. files: 1. Photograph and Image Release Being over 18 years of age, I give permission to the Inter-Cultural Association of Greater Victoria to take photographs of me during my participation in the following ICA program or service. I consent to and understand that these photographs and images of me may be displayed on the ICA website, newsletter, promotional material and/or as part of a project report or other publication. I agree to the Photograph and Image Release policy. Privacy of Personal Information Policy ICA abides by the BC Personal Information Protection Act. ICA will not use your personal information other than for the purpose intended without your express permission. If you wish further information about ICA’s privacy policies you may speak to ICA’s privacy officer.(Required) I consent to ICA using the information contained in the application for the management of Volunteer Services. I consent to receive communications from ICA about news, promotions, or updates. I understand I can unsubscribe or withdraw my consent at any time by clicking the unsubscribe link in emails or by phone. Agreement of Confidentiality I agree to keep all information related to the Inter-Cultural Association of Greater Victoria (ICA), its staff, clients, sponsored refugees, directors, programs, and financial matters confidential, unless publicly available or authorized for disclosure. I will not discuss ICA business outside of work unless necessary for my role. I will not remove any confidential materials from ICA premises unless required for my duties and authorized to do so. If unsure about disclosing information, I will consult with the CEO of ICA.(Required) I agree to the Confidentiality Agreement. Privacy Policy We keep your personal information private and secure. When you submit this form, your name, contact information, and any additional information will be available only to our organization. (Required) I understand that submission of this application does not guarantee acceptance as a volunteer with ICA and that ICA is under no obligation to accept me as a volunteer. Signed On DD slash MM slash YYYY Signature(Required)CaptchaThis field is hidden when viewing the formPrograms (Admin Only)This field is hidden when viewing the formDate (Admin Only) DD slash MM slash YYYY This field is hidden when viewing the formApplication Status (Admin Only)This field is hidden when viewing the formDOC_TYPE1
