Thank you for your interest in becoming a SASMAD/PHC volunteer !

Our staff will get in touch with you and provide the proper follow-up to your application

Become a volunteer

Form to register new volunteers to the service of spiritual accompaniment of Pastoral Home Care / SASMAD

Name*
First Name Last Name
E-mail
Address :*
Postal Address line 1 Postal Address line 2 City Province Postal Code
Telephone 1*
Telephone 2
Current occupation
Parish
Please indicate the territory of the Parish that you usually attend (optional)
Sector and coordinator
Please indicate the sector where you live in and/or the name of the PHC/SASMAD coordinator you have been in touch with
Do you have any allergies ? :*
(cigarette smoke, cats, dogs, others) If you do not have any allergies please write "none".
Spoken Languages*
Please indicate all languages that you feel comfortable for accompanying
- English
- French
- Spanish
- Arabic
- Italian
Other spoken languages
Please indicate if you speak any other language(s) in which you would feel comfortable accompanying people
Fields of interest, skills or leisure activities :
We will try to match you with a beneficiary who shares some of your interests
Have you volunteered for other organizations?*
If so, please describe your tasks and responsibilities.
How can your experiences and skills be beneficial to PHC/SASMAD?
How did you hear about our Service? :
Name of your Emergency contact and relationship to you :*
Please indicate at least one telephone number of your emergency contact :*
Name, relationship to you of Referral no. 1 :*
As part of the Program of responsible pastoral services, we need to collect at least 2 positive referrals for you. Kindly, provide us with the name and one phone number of 3 people who can help us to know you better. They should be people who know you well but are not your relatives. Example : co-workers, friends, parishioners, supervisors, neighbours.
Telephone number of Referral no. 1*
Name, relationship to you of Referral no. 2 :*
As part of the Program of responsible pastoral services, we need to collect at least 2 positive referrals for you. Kindly, provide us with the name and one phone number of 3 people who can help us to know you better. They should be people who know you well but are not your relatives. Example : co-workers, friends, parishioners, supervisors, neighbours.
Telephone number of Referral no. 2*
Name, relationship to you of Referral no. 3 :
As part of the Program of responsible pastoral services, we need to collect at least 2 positive referrals for you. Kindly, provide us with the name and one phone number of 3 people who can help us to know you better. They should be people who know you well but are not your relatives. Example : co-workers, friends, parishioners, supervisors, neighbours.
Telephone number of Referral no. 3
Message or additional comments (optional) :
Thank you so much for your registration !
Our staff will be in contact with you to confirm your application.

Thank you for your interest in becoming a SASMAD/PHC volunteer !

Become a volunteer

Thank you so much for your registration !