Date of Application *

MM

DD

YYYY

Full Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number (Home) *

(###)

###

####

Phone Number (Cell)

(###)

###

####

Phone Number (Other)

(###)

###

####

Next of Kin

First Name

Last Name

Phone Number

(contact number for next of Kin)

(###)

###

####

Do you have any allergies? *

Yes

No

Do you have a valid Driver's Licence? *

Yes

No

Do you have a valid passport? *

Yes

No

Are you legally entitled to work in Canada? *

Yes

No

Have you ever been employed by or volunteered with a Search & Rescue team? *

Yes

No

Type of volunteer work that interests you (Check all that apply): *

Fundraising

Searcher

Team Leader

Search Manager

Instructor

Board of Directors

Computer Work

Administration

Other

Are you currently employed? *

Yes

No