MyImpactPage - Application Form - Older Adult Centres

PERMISSIONS AND AUTHORIZATIONS

*I authorize the Corporation of the City of Thunder Bay to contact the persons and organizations listed for the purpose of obtaining reference information.

* I give permission for the Corporation of the City of Thunder Bay to save my information for purposes of contacting me for future volunteer opportunities.

* I permit the Corporation of the City of Thunder Bay and their agents to use any photographs, video tape, or other media taken of me during volunteering activities and related activities for purposes of promoting, administering, and managing current and future activities and related events. I waive claims for compensations for such use.

* I understand I may be required to submit and pass a vulnerable sector screening and/or criminal record check of which information that can be legally disclosed will be made available to relevant parties such the Corporation of the City of Thunder Bay, and appropriate authorities.

* Personal information contained on this form is collected for the exclusive use of the Corporation of the City of Thunder Bay and the Thunder Bay 55 Plus Centre. Information will be used to contact you to volunteer for the event, and if you provided consent, to contact you for other volunteer opportunities. Questions about this collection of personal information can be directed to: tessa.hettrick@thunderbay.ca

* Should you wish to revoke your consent for any of the aforementioned items, you can do so at any time by contacting the following:

Tessa Hettrick
tessa.hettrick@thunderbay.ca
807-684-3277

I am new to MyImpactPage.com

You will need to enter a unique username to identify yourself to the system. You should select something that is easy for you to remember such as your email address or your name. Your username must be at least 6 characters long. If the name you enter is already in use by someone else, you will be prompted to choose another username.

Username

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	Username must not start with space
	Username must not end with space
	Username must not have two or more spaces in a row

Email Address

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Verify Email Address

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I have read and agree to the Volunteer Policies Required

I already have a username

If you have signed up with this organization before, or are a member of another organization that uses MyImpactPage.com, you can use the same login to access all organizations with which you are associated.

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Password	Required
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I have read and agree to the Volunteer Policies Required

Already use MyImpactPage.com to volunteer with this organization? Go to volunteer login

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