Clinical Counselling Volunteer Name* First Last Address* Street Address Address Line 2 City Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code Primary Phone*Secondary PhoneEmail* Why you are interested in being a volunteer counsellor?*What are your education, qualifications and skills related to this volunteer position?*Which of the following approved colleges are you registered with?* College of Registered Psychotherapists of Ontario College of Psychologists of Ontario Ontario College of Social Workers and Social Service Workers Describe your previous experience in providing brief counselling, coaching or single-session*Do you have experience with any of the following?* Trauma (sexual and other) Mental health issues Work issues Couples Family violence LGBT counselling Other If other, please specify*I am willing and able to commit to volunteering on Wednesday evenings from 3:00 to 8:30 pm for at least two 5.5 hour shifts per month for a minimum period of 6 months*YesNoLanguages I can provide counselling in are*Coverletter*Resume*How did you hear about this volunteer position?*FST WebsiteInternet searchVolunteer TorontoCharity VillageFST StaffFST VolunteerFriend/colleagueCommentsThis field is for validation purposes and should be left unchanged.