Name*

First Last

Address*

Street Address Address Line 2 City Province Postal Code

Email*

Phone*

Phone Type*

Education

Employment

Volunteer Experience

Languages Spoken

WAG Volunteer

I have previously volunteered with the WAG

Please provide details on your previous WAG Volunteer experience

Interest *check all that apply*

Availability *check all that apply*

Please provide at least 2 references, with contact information specified*

Consent*

I hereby authorize the Winnipeg Art Gallery to contact the above named reference to establish my suitability as a volunteer and I hereby release them and their company from all liability for any damage for issuing same. I further authorize the human resources department to maintain this information in their records and release and absolve them from liability that may otherwise accrue by reason of their keeping this information and using it for their purpose. Disclaimer: It is the policy of the Winnipeg Art Gallery to screen all prospective volunteers. While we try to place every applicant, we reserve the right to select applicants according to our needs and criteria.

I understand and respect the confidential nature of information I might have access to in performing my volunteer duties for the Winnipeg Art Gallery.

I agree

Sharing of Personal Information

I authorize the Winnipeg Art Gallery to publish my name in WAG promotional materials

I agree

Signature

Parent / guardian signature if under 18 years old

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