Manitoba Driving Society

Application for Volunteering

Name(s):

 

 
Address:

Phone:
City: Province: Postal Code:
E-mail:

Age Bracket (check off which ever of the following that applies):

A) 12 & Under      B) 13 to 17             C) 18 to 29             D) 30 to 40             E) 41 to 54              F) 55 plus

Applicant Signature                                                                                            Date:

Guardian Signature (If  the applicant is under 18 years of age)

Manitoba Driving Society Volunteer

Contact Information:

Name Address Phone Email
Ruth Rob

Box 214A
RR #2
Dugald, MB
R0E 0K0

 (204) 444-3557 robassoc(AT)mts(DOT)net
Carol Brand Box 101
East Selkirk, MB
R0E 0M0		 (204) 482-6142 ifrazerb(AT)mts(DOT)net