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Your Information
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First Name*
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Middle Name
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Last Name*
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Date of Birth (MM/DD/YYYY)*
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Gender*
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Email*
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Street Address*
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City*
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Province
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Postal Code*
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Home/Primary Phone*
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Mobile Phone (if different)
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Current school*
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Grade*
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If you are also currently employed, where?
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I have been a volunteer with another child/youth serving organization.ed with child/youth serving program?
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Do you speak any language(s) other than English?*
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Were you born in Canada*
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Ethnic Identity - National*
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Emergency Contact Name*
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Emergency Contact Relationship*
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Emergency Contact Phone*
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Click "Next" to continue your application. At any time you can click "Previous" to review or edit previous pages.
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