Serve! Engaging Youth for Change

apply

Serve! engages diverse youth in experience-based education, teamwork and community involvement so that they may establish personal direction, overcome obstacles, achieve goals and contribute to society.

Summer 2009 Registration

First & Last Name:


E-mail address:


Full Mailing Address:


City:


Province:


Postal Code:

Home Telephone Number:


Other Telephone Number (cell):


Parent or Guardian's Name:


Current Age:


Date of Birth (month/day.year):

Sex/Gender Identity:


Languages you speak:
English French
Other

Is there a medical/physical condition or challenge that we need to accommodate to enable you to participate in the Step Up program (physical disability, allergy, learning disability, literacy challenges, etc.)?
If yes, please explain:

Are you legally entitled to work in Canada?


Do you have a Social Insurance Number (S.I.N.)?


What school you attend:


What grade are you in?:

How did you learn about this program?
(teacher, community, agency, web site, friend, other):


Which program are you applying for?


Have you participated in Serve’s March Break or Summer program before?:




Privacy Policy: Your information will only be used by Serve! for the purpose of sending you information regarding Serve!. Your information will not be distributed for any other purpose without your express permission.
A full-time six-week summer program for youth 13 to 16 years of age. Participants engage in volunteer activities and work on personal skills development and team-building in a fun, interactive setting.



BNR: Fully Clothed is a signature fundraiser for Serve!


Please Join us for an Al Fresco Musical Celebration
Hosted By: Seamus O’Regan of “Canada AM” and Colin Mochrie of “Whose Line is it Anyway?”

Honorary Chairs: Colin Mochrie and Deb McGrath of “Little Mosque on the Prairie”