Coffee House Volunteer Application

Thank you for your interest in volunteering at Extreme Coffee House. 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 (required)
MaleFemale

Last Name (required)

First Name (required)

Upload your picture (5mb limit) (required)

Date of Birth (YYYY-MM-DD) (required)

Age (required)

Street address (required)

City (required)

Province (required)

Postal Code (required)

Home Phone (required)

Cell Phone (required)

Email address (required)

If you are under 18 years old, please provide the following:

Name of Parent or Guardian

Phone number of Parent or Guardian

Preferred Method of Contact (required)
PhoneEmail

Please Note: Half and full day volunteer shifts are available Monday-Friday.

I have read your website and agree with the Mission Statement of Extreme Outreach Society (view our website at: www.extremeoutreach.com)

REFERENCES

WORK REFERENCES (2 REQUIRED)

Reference 1

Full Name (required)

Address (required)

Phone # (required)

Email (required)

Reference 2

Full Name (required)

Address (required)

Phone # (required)

Email (required)

PERSONAL REFERENCES (1 REQUIRED)

Reference

Full Name (required)

Address (required)

Phone # (required)

Email (required)

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?

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

Emergency Contact Person

Emergency Phone

Emergency Work Phone

Thank you for applying to volunteer at the Extreme Coffee House! Once we have reviewed your application and have contacted your references we will be in touch with you to discuss specific opportunities. Please note that a criminal record check is required for all volunteers and will be requested prior to final acceptance. A few additional forms will also be required to complete the process.