Volunteer Application

Printable Volunteer Application Here

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: _______________________________________________


Describe why you would like to be part of the 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 __________________________________________________________________________________________________________________________________________________________________________________________________________________

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 (crc) 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: bjjanz86@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.

If fingerprinting is required, please contact Janet Janz (bjjanz86@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, Anna or Janet (bjjanz86@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.

Are you aware of any medical condition that we should be aware of? Yes _____ No _____

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. 

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