First Name (required)
Last Name (required)
Postal Code (required)
Home Phone (required)
E-Mail Address (required)
Employment Status (required)
Citizenship Status in Canada Status (required)
---Canadian CitizenPermanent ResidentWorking Holiday VisaWork PermitStudent VisaOther
Termination Date of Visa:
If under the age of 19, please complete the following:
Name of Parent/Guardian:
Are you fluent in English (5 is VERY Fluent)
Spoken ---543210 Written ---543210 Read ---543210
Are you fluent in Japanese (5 is VERY Fluent)
Length of volunteer commitment:
Number of Months? (Required)
Number of Hours per Week? (Required)
Volunteering Interests (Tell us about yourself!)
In terms of volunteering, we have many areas of volunteerism. Please check off as many as you like (Required).
1 to 1 visiting Arts or Drama Cooking Crafts Dementia friendly Driving/Escorting Entertaining Excercise Game focused work Leading discussions Music related Office work Performances
Do you have other special skills, qualifications, or licenses?
Team Work: Our programs have a teamwork orientation. It is important that you like to work in a team, and sharing and collaborating with the participants and volunteers.
What kinds of things do you pay attention to the most working as a team member?
As a team member, we value what you want out of your volunteering experiences.
Please describe in a few words what brings you the most joy and what you hope to gain from volunteering?
Can you tell us your most memorable volunteer experience?
What do you enjoy doing in your free time?
Challenges: If there are any areas or situations you find challenging, please let us know. For example, working on numbers, very shy, etc.?
Please provide two (2) references (Required):
Reference 1 Name (First and Last)
Reference 2 Name (First and Last)
*FOR VOLUNTEERS OF NIKKEI SENIORS (Required)
Do you have knowledge/experience/skill with seniors or seniors issues?
If Yes, please describe:
Person to contact in case of emergency:
I declare that I have answered all questions in this application fully and truthfully. I give permission to Nikkei Place to disclose my personal information for internal purpose only.
Please type your FULL legal name:
Thank you for your interest in volunteering at Nikkei Place! Please SUBMIT this completed form by clicking on the submit button below.
If the page errors out there is probably some missing data or some missing answers. If the form submits properly, you will be presented with a new blank form.
Thank you for your interest in volunteering at NikkeiPlace. We will contact you once your submission has been reviewed.