Online Volunteer Application Operation Red Nose Online Volunteer Application Thank you for your interest in helping get Manitobans home safe and sound this holiday season. Complete the following form to submit your application, or contact us if you have any questions. If you are human, leave this field blank.Have You Volunteered With Operation Red Nose Before? *YES, I am a RETURNING volunteerNO, I am a NEW volunteerDo You Require A Volunteer Recognition Certificate? *YESNOFirst Name *Last Name *Birth Date *SexMaleFemaleNon-binaryHouse # *Street Name *Street Suffix *AvenueBayBoulevardCircleCloseCourtCoveCrescentDriveGateHighwayLanePlacePointRoadStreetTerraceWayOTHER/NOT LISTEDStreet DirectionNorthSouthEastWestCity *Postal Code *Phone Number *Phone Type *HomeWorkMobileAdd Another Number2nd Phone Number *2nd Phone Type *HomeWorkMobileAdd Another Number3rd Phone Number *3rd Phone Type *HomeWorkMobileEmail Address *Which Organization Are You Representing? *Community (None)CorporateManta SwimmingSwimmer Name *Company Name *Do You Have A Drivers License? *YESYES, but NON MANITOBANNODriver's License Number *Format: **–**–**–******Non MB Driver's License Number *License Expiry *Comfortable Driving Standard? *YESNODo You Have License Restrictions? *YESNOPlease Explain Your License Restriction(s) *Primary (Photo) Identification: * Primary (Photo) I.D must be one of the following: Driver’s License Passport Permanent Resident Card Aboriginal Status Card Manitoba Public Insurance Identification Card Secondary Identification: * Secondary I.D must be one of the following: Birth Certificate Social Insurance Card – (SIN confirmation letters effective April 2014) Provincial Health Card Citizenship Card Firearms License Immigration Papers National Defense Card Nexus Card FAST CARD from Canada Border Services Agency Criminal Offence(s) *I HAVE NOT been convicted of a criminal offence in Canada or elsewhere or, if I have been convicted of a criminal offence, I have obtained a pardon.I HAVE been convicted, in Canada or elsewhere, of one or more criminal offences.Pending Charge(s) *I AM NOT subject to any pending charges for a criminal offence in Canada or elsewhere.I AM subject to one or more pending charges, in Canada or elsewhere, for one or more criminal offences.Court Order(s) *I AM NOT subject to any court order made against me in Canada or elsewhere. I AM subject to one or more court orders made against me in Canada or elsewhere.Offence/Charge/Order Description *Date Of The Event *Place Of The Event *Your Signature *Reset SignatureSignature is required.Terms & Conditions *I authorize Operation Red Nose (ORN) and any police service with jurisdiction over any or all parts of the province in which I reside to conduct a criminal record check to ensure that I meet the selection criteria set out by ORN that appear on the back of this form. However, only judicial antecedents that ORN deems to be incompatible with the volunteer’s assignment will be taken into account. If my assignment requires the driving of a road vehicle, I authorize ORN and any police force to check the validity of my driver’s licence. I also give my consent to the police force to forward the results of the background checks to ORN. A false declaration will result in the refusal of the application. Furthermore, between the time I submit this form and the time I participate as a volunteer, I will inform ORN of any new charge(s) against me relating to an offence and any conviction(s) in connection with such an offence. In accordance with the relevant legislation, ORN and its representative agree to protect the confidentiality of all information and data about the organization’s clients and volunteers. Any declaration form that has not been signed or that contains unanswered questions will be considered incomplete and returned to sender. I also agree to comply with the volunteer commitment set out on the back of this form, which I have read and understood. I certify that the information provided in this declaration is accurate and complete.I AgreeI DO NOT AgreeYOU MUST AGREE TO THE TERMS & CONDITIONS IN ORDER TO SUBMIT YOUR APPLICATIONSUBMIT YOUR APPLICATION Thank you for your support!