LPCG Volunteer Application Form

Please fill out this form completely. We will forward this information to our sponsor, the Ministry of Community, Family and Children's Services. We cannot process your application unless we have all the required information below. If accepted, you will receive confirmation e-mails to the e-mail addresses you supplied, and will need to confirm by replying from that address. Once we receive verification, you will be assigned a LPCG ID number, which you will use to access the site. Please include this number in your emails any time you correspond with us.

Incomplete forms will be rejected

(Be sure to read out Terms of Reference before you sign up. By tendering your application, you confirm that you agree to adhere thereto and agree with their terms)

Name and E-mail:
First Name:
Middle Name or Initial:
Last Name:
E-mail:
Note: This must be an E-mail Address from your home e-mail and not a free e-mail account or re-mailer like Hotmail. We must have a valid home ISP mail for security reasons. Your application cannot be processed without this.
Alternate E-mail:
Note: Free-mail addresses are allowed for secondary contact
Please describe in the box below any experience you have relating to your volunteering as an LPCG member:
Disability:
If you yourself are a disabled person, please specify your disability.
Please name any disability related committee, or association with which you are a member.
Contact Information:
The following information is required of all members and is made known only to the executive members of this LPCG organization and the Ministry of Community, Family and Children's Services:
Street Address:
City:
Province:
Postal Code:
Telephone (include area code):
Online Information:
Nick or Chatroom Handle:
Operating System:
Time Available Online: hours
Daily or Weekly or Monthly
Why are you interested in volunteering?
How did you hear about us?
How You Think You Can Help:
Membership Agreement: (Please enter your name again below.)

I, , apply to be a volunteer for the Ministry of Community, Family and Children's Services, Northern Region, ODSP Employment Support Program's, Local Planning and Co-Ordination Group. I understand that The Ministry reserves the right to accept or reject any application, for any and for no reason, in their sole and absolute discretion. I also acknowledge that I remain a volunteer at the sole discretion of the Ministry, and may be removed or terminated with or without cause at any time. A Volunteer must be officially accepted and enrolled by the Ministry prior to participating in the LPCG's, or their primary communication tool, www.virtual-LPCG.

If accepted as a volunteer for the LPCG, I will adhere to the LPCG Terms of Reference. I further agree to be bound by this confidentiality agreement, and I understand that I am prohibited from disclosing any information that I obtain during the course of my work for the Ministry unless authorized by appropriate Ministry management.

I understand that this obligation is a continuing one, and will survive my tenure in the LPCG. I further agree that all materials and information provided to me by LPCG will be returned to the Ministry and that all materials developed or modified by me during the course of my activities for the LPCG shall be the property of the Ministry (unless otherwise agreed in writing).

I have read and agree with the LPCG Terms of Reference (Check box to the left)