You must have JavaScript enabled to use this form. Title * - Select -Mr.Mrs.Ms.Dr.Sr. First name * Last name * Address City Province - None -New BrunswickNova ScotiaPrince Edward IslandNewfoundland and LabradorQuebecOntarioManitobaSaskatchewanAlbertaBritish ColumbiaNorthwest TerritoriesYukonNunavut Postal Code Telephone Home * Work Cell Email * Languages Spoken English French Other Specify Written English French Other Specify Resume file Facility/facilities where you would like to volunteer Acadie-Bathurst Zone Enfant-Jésus RHSJ† Hospital Tracadie-Sheila Hospital Lamèque Hospital and Community Health Centre Chaleur Regional Hospital Beauséjour Zone Veterans’ Health Centre Dr. Georges-L.-Dumont University Hospital Centre Stella-Maris-de-Kent Hospital Northwest Zone Grand Falls General Hospital Edmundston Regional Hospital Hôtel-Dieu Saint-Joseph de Saint-Quentin Restigouche Zone Campbellton Regional Hospital Veterans’ Unit Restigouche Hospital Centre St. Joseph Community Health Centre (Dalhousie) Regional Addiction Services Check the appropriate box: University or college student High school student Adult Where or with whom would you like to volunteer? Children Elderly people Oncology Lodge Greeting No contact with patients When are you available? Right now From Period(s) when available When? Were you ever registered as a volunteer or candidate in our department? Yes No How did you hear about the services provided by our volunteers? Friend Volunteer School/University or college Hospital Pamphlet Personal initiative Internet Other Other Tell us about you: (Training, experience, skills, current life situation, recent losses, retirement, work, reasons for volunteering, etc.) Message Leave this field blank