Volunteer Mediator Application form

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Name

Phone Number 1

Phone Number 2

Address

City

Province

Postal Code

Gender

Age

Ethnicity

Country of Birth

First Language

Other Languages

Reference 1: Name

Reference 1: Phone Number

Reference 1: Email

Reference 1: Relationship to you

Reference 2: Name

Reference 2: Phone Number

Reference 2: Email

Reference 2: Relationship to you

How did you find out about St. Stephen's Conflict Resolution & Training?

Do you have any previous experience or training in conflict resolution?

Why do you want to be a volunteer mediator?

Please describe your previous and current volunteer experience.

What in your experience or training gives you a level of comfort and knowledge in dealing with people with vulnerabilities and people who are often oppressed?

Is there anything else we should know about you?

Please attach your resume

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