Volunteer Recommendation Form

4-H Association*

Region

Volunteer Candidate Name*

First NameLast Name

Candidate 4-H Ontario ID#

On behalf of my local 4-H Association, I verify that the local 4-H Volunteer Screening Committee has completed a screening interview with this candidate.*

I agree

Based on the completion of the volunteer candidate's interview, does the local 4-H Volunteer Screening Committee have any concerns about this individual volunteering with 4-H?*

NoYes

Comments

The local 4-H Volunteer Screening Committee...*

Recommends this volunteer candidateDoes NOT recommend this volunteer candidate

Please check any fields in the 4-H Ontario MWA database that the local Screening Contact has updated.

Screening Interview CompletedLocal Recommendation Completed

Screening Contact Name*

First NameLast Name

Screening Contact Email*

example@example.com

Screening Committee Member Name*

First NameLast Name

Screening Committee Member Name

First NameLast Name

Screening Committee Member Name

First NameLast Name

Screening Contact Signature*

Date*

Date

Ontario 4-H Council (“4-H Ontario”) Privacy Statement - 4-H Ontario respects the privacy of its members, volunteers, donors, sponsors, staff and stakeholders. We are committed to ensuring that appropriate measures and safeguards are in place to protect specific information that is held for the purpose of 4-H Ontario programs. We adhere to legislative requirements with respect to privacy. We do not rent, sell or trade mailing lists. If at any time you wish to be removed from any of our contact lists, simply contact us by phone at 519-856-0992, toll free at 1-877-410-6748, by fax at 519-856-0515 or via our website at www.4-H Ontario.ca. We will gladly accommodate your request. For further information regarding our commitment to privacy, please contact 4-H Ontario’s Privacy Officer at privacy@4-hontario.ca.