I certify that all information on this application is true and I give permission for Compass Community Health to contact the above references. By signing below you give Compass CH staff permission communicate with you through the contact information listed above. Please note that Compass CH will not share your information outside of the Health Centre without your permission.
Please complete with full names and addresses, two people who know you well enough to evaluate your qualifications as a volunteer. Include at least one previous and/or present employer, if applicable: