Autism Ontario Regional Volunteer Application Form

AREA OF INTEREST
Please Check All That Apply:
ABOUT YOU
Preferred Method of Contact
Health Training - Do You Have:
Do You Have a Current Vulnerable Sector Check (that is less than 1 year months old)
One file only.
30 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.
SEAC Position

For more information about the roles and responsibility of a SEAC Rep, please click here.

I am interested in representing Autism Ontario on the Special Education Advisory Committee with the school board of:
English Catholic District School Board
French Catholic District School Boards
English Public District School Boards
French Public District School Boards
I am applying for the SEAC position of:
Autism Ontario SEAC Expectations
  • Commit to a 4-year term. (Or for the remainder of the term if applying after the start of a new term)
  • Attend 10 SEAC meetings per year.
  • Complete orientation and training required by Autism Ontario
  • Complete orientation and training required by my SEAC and/or school board
  • Follow the policies and procedures of Autism Ontario
SEAC Eligibility Criteria
  • I reside within the jurisdiction of the board I would like to represent.
  • My property taxes are designated towards the school board I would like to represent.
  • I am a Canadian citizen.
  • I am over the age of 18.
  • I am not employed by the Board of Education where I am applying to be a SEAC representative.
  • I have not been convicted of an indictable offense.
SEAC Eligibility Criteria:
  • I reside within the jurisdiction of the board I would like to represent.
  • My property taxes are designated towards the school board I would like to represent.
  • I am a Canadian citizen.
  • I am over the age of 18.
  • I am not employed by the Board of Education where I am applying to be a SEAC representative.
  • I have not been convicted of an indictable offense.
SEAC Eligibility Criteria
  • I reside within the jurisdiction of the board I would like to represent.
  • My property taxes are designated towards the school board I would like to represent.
  • I am a Canadian citizen.
  • I am over the age of 18.
  • I am not employed by the Board of Education where I am applying to be a SEAC representative.
  • I have not been convicted of an indictable offense.
REGION
Programs and Events Take Place Across the Region. Are You Willing/Able to Travel?
LANGUAGE
EMERGENCY CONTACT
AVAILABILITY
Please Check All That Apply:
Time of Day Preferred
REFERENCES
Activity
One file only.
30 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.
One file only.
30 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.
Please Check All That Apply:
How Did You Hear About Autism Ontario?
PERMISSION AND RELEASE

Permission and Release

  1. The references I listed may be contacted for the purpose of processing my application to become a volunteer with Autism Ontario. I understand that these references will be contacted in confidence;
  2. I am in no way obligated to perform any volunteer services for Autism Ontario;
  3. I understand that I will be required to provide a vulnerable sector check (at my own expense), as the position potenially involves working with vulnerable individuals;
  4. I acknowledge and accept that this application does not guarantee acceptance to a volunteer role, and that Autism Ontario is under no obligation to accept me as a volunteer, and is not obliged to provide a reason;
  5. I hereby release and forever discharge Autism Ontario, and their employees, directors, volunteers and contract staff from any cause or claim for damages, whether bodily injury, death, property damage, or emotional trauma, anxiety or distress arising from my association with Autism Ontario.
  6. I give permission to Autism Ontario to share any information that I’ve given them, pertinent to my application to volunteer, with appropriate staff and volunteers.
  7. If I am under 18 years of age at the time of my application, my parent/guardian will complete a consent form on my behalf.
  1. The references I listed may be contacted for the purpose of processing my application to become a volunteer with Autism Ontario. I understand that these references will be contacted in confidence;
  2. I am in no way obligated to perform any volunteer services for Autism Ontario;
  3. I understand that I may be required to undergo a Vulnerable Sector Screening check, if the position involves working with vulnerable individuals;
  4. I acknowledge and accept that this application does not guarantee acceptance to a volunteer role, and that Autism Ontario is under no obligation to accept me as a volunteer, and is not obliged to provide a reason;
  5. I hereby release and forever discharge Autism Ontario, and their employees, directors, volunteers and contract staff from any cause or claim for damages, whether bodily injury, death, property damage, or emotional trauma, anxiety or distress arising from my association with Autism Ontario.
  6. I give permission to Autism Ontario to share any information that I’ve given them, pertinent to my application to volunteer, with appropriate staff and volunteers.
  7. If I am under 18 years of age at the time of my application, my parent/guardian will complete a consent form on my behalf.
Sign above