Coffee House Volunteer Application

Thank you for your interest in volunteering at Extreme Coffee House. Please fill out the form below, and a team member will be in touch. *If you are between the ages of 15-25 and interested in receiving Youth Job Skills Training at our Coffee House, CLICK HERE to learn more and apply.

Gender

Male Female

First Name

Last Name

Upload your picture

Date of Birth

Age

Street Address

City

Province

Postal Code

Phone Number

If you are under the age of 18, please provide the following:

Parent/Guardian First & Last Name

Parent/Guardian Phone Number

Parent/Guardian Email

Reference 1

Full Name

Work Reference or Personal?

Work Personal

Phone Number

Reference 2

Full Name

Work Reference or Personal?

Work Personal

Phone Number

Emergency Contact

Emergency Phone

Emergency Work Phone

Mission Statement Agreement

I have read your website and agree with the Mission Statement of Extreme Outreach Society

If you have any past experience that is applicable to a coffee house environment, please let us know here

Do you have any allergies?

Do you have any medical conditions or other health notes for us to be aware of?

The Coffee House requires volunteers to be able to lift boxes packed with products in addition to performing other physically demanding tasks. Please state if you are able and willing to do these tasks as part of the Coffee House volunteer position

Yes No