Volunteer Application
We appreciate your interest in volunteering with the Refresh Mobile Shower Ministry! Please fill out the following application form.
Personal information
First name:_____________________________________________
Last name:_____________________________________________
Street:________________________________________________
City:____________________________ Postal Code:_______________
Cell phone___________________________________
Email address:________________________________
Date of birth:______________________ Gender: ___________________
Church affiliation (if any):______________________________________________
Pastor’s Name:__________________________________________________
MINISTRY INFORMATION
Describe why you would like to be part of Refresh Mobile Shower Ministry ? ___________________________________________________________________________________________________________________________________________________________________________________________________
What strengths or assets would you bring to our Ministry? __________________________________________________________________________________________________________________________________ _________________________________________________________________ How do you hope to benefit? ________________________________________________________________ ________________________________________________________________ _________________________________________________________________
List any previous volunteer experiences __________________________________________________________________________________________________________________________________
Are you aware of any medical condition that we should be aware of? No______ Yes__________________. If yes, please specify:_________________________ ______________________________________________.
Have you taken any courses or received any training that would be beneficial to have for this Ministry? ( eg.Naloxone or First Aid training)
_________________________________________________________________ _________________________________________________________________ >While not required, would you be willing to take Naloxone and/or first aid training? _________________________________________________________________
REFERENCES (One reference should be a family member)
1. Name of Reference __________________________________________________________
Address _____________________________________________________________________
Phone Number _____________________ Nature of relationship ________________________
E-mail _______________________________________________________________________
2. Name of Reference __________________________________________________________
Address _____________________________________________________________________
Phone Number _____________________ Nature of relationship ________________________
E-mail _______________________________________________________________________
Background Check
Refresh Showers needs a current criminal record check for the vulnerable sector. You will not be allowed to volunteer without one. They need to be done every 5 years. If you happen to already have a check from within the last 5 years, simply scan and send it by email to: josiegerbrand1@gmail.com
If you do not have a current crc, you can fill out the application and pay online @ https://www.abbypd.ca/criminal-record-check or go to the police station. You will be applying for a “Police Information Check- Vulnerable Sector” as a volunteer- $37.45
If fingerprinting is required, please contact Josie (josiegerbrand1@gmail.com) for a letter of reference so they waive the extra fee.
We need a copy of your results for our files. Please submit your results and your receipt for reimbursement to either Henry, Ed or Josie (josiegerbrand1@gmail.com)
Confidentiality Agreement
Confidentiality can be a life or death issue for people who are homeless. As a volunteer of the Refresh Mobile Shower Ministry Program, I agree to hold information regarding people I encounter while volunteering and their condition in confidence. This includes not sharing camp locations. Conversations about individuals being served and their situations, without their consent are violations of the trust, respect and privacy to which they are entitled.
• Do not share your personal contact information with individuals being served (address, phone number, email)
• Do not transport individuals being served in your personal vehicle.
• Connecting and building healthy wholesome relationships between volunteers and individuals being served is encouraged. It is important that these relationships be developed carefully and respectfully, recognizing that many individuals being served are emotionally, socially, spiritually, and physically vulnerable. With this in mind, please do not visit camp locations outside of Refresh Mobile Shower Ministry events.
I agree to abide by the Refresh Mobile Showers confidentiality agreement (as seen above).
Training Manual
I have read and understood the Refresh Mobile Shower Ministry Training Manual and agree to uphold the requirements and guidelines.
By signing this form you agree with the information above
Print name_______________________________ Date____________________________
Signature ________________________________________
You will be contacted once we have reviewed your application and checked your references.