Staff Contact Information - Virtual Ventures

Staff Information

Name*

First Last

Student Number*

Email (Carleton CMAIL only)*

Program, Year*

Example: Aerospace, 2 (year completed, not year standing in the Fall)

T-shirt Size*

AS = Adult Small etc.

Cell Phone Number*

Allergies/Dietary Restrictions/Medical Conditions*

Please include all dietary restrictions and allergies. If none, please say "N/A or none"

Address*

Your current address (would be used to ship materials and supplies to you if needed)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Certifications & Documents

Do you have a Police Record Check (PRC)?*

New staff: We require a Police Record Check for the Vulnerable Sector (level 3 with Ottawa Police or equivalent) validated on or after August 1 2021. If you do not have one to submit, you will ned to request a new one which we will reimburse you for.

Returning Staff: if you submitted your PRC in May 2021 or later, you do not need to submit a new one. If you did not submit one in May 2021 or later, you will need to submit a new one which we will reimburse you for.

Returning staff not submitting a new one, please select "Yes, I have sent it over email already"

*If you selected "No, I have not requested one yet" please request one now.

Yes, I have sent it over email already
Yes, I will attach it here
No, I have requested one but not received it yet
No, I have not requested one yet

Did you request a PRC for this job and will be submitting for reimbursement?*

A reminder, we will need the original copy if submitting for reimbursement.

Yes
No

Police Record Check*

What Date did you request your Police Record Check*

Drivers License*

Full G (or equivalent)
G2 (or equivalent)
Do not have a Driver's License

Other Commitments

Are you planning to take any summer courses?*

Early (May-June)
Late (July-August)
Full (May-August)
None

How many courses are you planning on taking?*

Do you have any other commitments outside of this position?*

Example: another part-time job

Yes
No

Please let us know your other commitments and if it would affect your work hours in any way*

*including weekly evening commitments (as in July-August we will meet once a week for a staff meeting after camp

Emergency Contact 1:

Name*

First Last

Relationship to you*

Cell Phone Number*

Home Phone Number

Work Phone Number