Dispatcher Application

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URL

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First Name*

Last Name*

Phone*

Email*

Address*

City*

Postal Code*

I am interested in becoming a*

Date of Birth*

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Year*

Personal Reference – First Name*

Personal Reference – Last Name*

Relationship to you?*

Contact Number*

Experience*

Please tell us about any work, computer, or volunteer related skills that would benefit you as a dispatcher.

Code of Ethics and Privacy Policy

In volunteering with VCDS I will:

Keep any and all volunteer and/or patient information confidential.

Not share this information (intentionally or unintentionally) with anyone outside of VCDS and will use it only for the purpose intended.

Keep any records (and will ensure their destruction) in a safe and secure manner.

Make the safety and security of the people we transport my highest priority.

Ensure that my actions and behaviour when volunteering meet the highest ethical standards.

Not benefit or attempt to benefit financially or otherwise from my volunteer activity. Respect the customs and culture of my team members and those we serve

Not discuss a patient’s health situation unless specifically invited to do so and never provide medical or other advice.

I understand that as an active volunteer my name, address, phone #, and email address will be shared with team members as appropriate. This information may also be shared throughout our organization on team lists and/or in emails.

I AGREE to the VCDS Code of Ethics & Privacy Policies*

By selecting the “I AGREE” box you are acknowledging to abide by these terms.

I AGREE

Acknowledged On*

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Year*

How did you hear about us?*

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Which Service Club?*

Describe how you heard about us*

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