e-Health Student Volunteer Application

Are you a Digital Health Canada Student Member? *

Yes
No

At which academic institution are you currently enrolled? *

Please upload proof of full-time enrolment in the form the form of a letter from the registrar or similar official. *

Drag & Drop Files, Choose Files to Upload

you be enrolment

Please confirm that you will be available to attend one online orientation session. *

Yes, I am available to attend the online orientation session on May 20 from 1:00 p.m.–2:00 p.m. ADT
Yes, I am available to attend the online orientation session on May 27 from 1:00 p.m.–2:00 p.m. ADT

Please confirm that you will be available to attend the mandatory onsite training session on June 13. *

Yes, I am available to attend the mandatory onsite training session on June 13 from 12:00 p.m.–5:00 p.m. ADT

Please check all times you are available to volunteer.

All volunteers wear a t-shirt identifying them as an e-Health volunteer. The t-shirt will be supplied by e-Health and is yours to keep. Please select your preferred size.

Sizing for volunteer t-shirts is gender neutral.

Name *

First

Last

Email *

Phone *

City, Province *

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