The AIDS Network ~ Serving Hamilton, Halton, Haldimand, Norfolk & Brant

Vision
To prevent HIV transmission and to help people living with HIV/AIDS become informed, accepted and self-determined.

Mission
To recognize and respond to the stigma and challenges posed by HIV/AIDS on individuals and communities through education and support.

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Corporate & Community Campaigns
Ways to Help
Become a Member

Ways to Help / Volunteer Application

Full Name:
Street:
City:		Postal Code:
Home Phone:		Cell Phone:
Work Phone:
Birth Date:		Age:
Email:
Best Way to Contact You:
Best Time to Contact You:
Occupation:
If not currently employed, recent work experience:

Education:
Special Interests:
Languages Spoken/Written:
Driver's License?:
Access to a Vehicle?:
Availability: (i.e. # of hours per week/month & morning/afternoon/evening/weekends):

Can you commit for 1 year?:	(Students Exempt)

Please list previous Volunteer Experience:
Organization [1]:		Year [1]:
Duties [1]:
Organization [2]:		Year [2]:
Duties [2]:
Organization [3]:		Year: [3]:
Duties: [3]:
Why would you like to become a volunteer at The AIDS Network?

Please list 3 references we may use on your behalf. References should be over 18 years of age, have known you 3 years or longer, and must not include your doctor, therapist or social worker:
Name [1]:		Phone # [1]:
Relationship [1]:
Name [2]:		Phone # [2]:
Relationship [2]:
Name [3]:		Phone # [3]:
Relationship [3]: