Volunteer Application Form

Volunteer Application Form

The aim of the CSCHN’s volunteering program is to promote the health of the Francophone community by offering individuals the opportunity to play an active role in their own well-being and the well-being of their community through various forms of volunteering.

Thanks to the Ontario Trillium Foundation, this program has forged partnerships with other organizations that need the help of French-speaking volunteers. These partnerships therefore open up a wider range of opportunities for volunteers while enabling organizations to benefit from easier access to volunteers with the necessary language skills.

With this online application form, we will be able to add your name to our bank of French-speaking volunteers and, knowing your personal interests and availability, match you with the role that suits you best.

Once you have completed the form, click “Submit”; you will receive an automatic confirmation that your form has been submitted successfully.

If you experience any difficulties with the form, please contact Kankou Camara at kankou.camara@cschn.ca or 905-734-1141 ext. 2351 / 1-866-885-5947. You may also email r-h@cschn.ca or call 905-734-1141 / 1-866-885-5947.



Formulaire de messagerie par courriel

Permission parent

Protocole de confidentialité



The Centre de santé communautaire Hamilton/Niagara (CSCHN) recognizes the importance of protecting the privacy of the personal information with which it is entrusted. By personal information, we mean any information that identifies you directly, such as your full name, home address, email address or phone number, as well as any comments you may make regarding the CSCHN.

The personal information we collect from you is used to draw up the official list of CSCHN volunteers. Your information may be shared with certain employees who may contact you about volunteering for the CSCHN. A CSCHN volunteer or employee may also contact you to provide you with information regarding events that may be of interest to you as a volunteer. Rest assured that your personal information, such as your name and contact details, will not be shared or sold to anyone without your express permission and except for the purposes mentioned above.

We also collect information that cannot be used to identify you personally, such as your age group, skills and interests, in order to gain an overall picture of the CSCHN’s volunteer pool and meet the requirements of specific volunteer roles. Please contact Mr. Bonaventure Otshudi, Acting Executive Director, for further information regarding the CSCHN’s policies and practices concerning the collection, use and disclosure of personal information. If you would like your email address to be removed from our database, please send a message containing the words “ANNULER COURRIER” to kankou.camara@cschn.ca or r-h@cschn.ca. Please allow two to three working days for the cancellation to take effect.


Volunteer registration form
First name
Last name


Please check the boxes if you have taken these courses
e.g. inability to lift weights

Your skills and interests

Please describe any paid or unpaid jobs that may be helpful in your volunteer duties
Check all that apply to your preferences

Your availability

The Centre de santé appreciates all those who contribute their time, however, a minimum of 10 hours per year is required to be considered as a volunteer at the CSCHN.
Please provide two non-family references (include name, relationship and contact information)
Please note that community partners of the volunteer program have all signed a confidentiality agreement regarding the use of volunteers' personal information
Please enter your name if you agree to these conditions.
A criminal record check is mandatory for volunteers who work directly with clients at the CSCHN. This process is necessary to ensure the safety and protection of both clients and other volunteers and staff. If you have a criminal record check completed in the last year, please indicate it.
Postal Code