Fillable Appendix D Request For Vulnerable Sector Check (Volleyball Alberta)

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Appendix D Request For Vulnerable Sector Check (Volleyball Alberta)

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This is a Pan-Canadian Policy applicable to Volleyball Canada and the Provincial/Territorial Associations.
www.volleyballalberta.ca
Page 1 | 1
Appendix D – Request For Vulnerable Sector Check
IN
TRODUCTION
[
Volleyball Alberta] is requesting a Vulnerable Sector Check for _____________ [insert individual’s full name] who
identifies as a _____________ [insert gender identity] and who was born on ______________ [insert birthdate].
D
ESCRIPTION OF ORGANIZATION
[Volleyball Alberta] is a not-for-profit provincial organization for the sport of volleyball located in [Alberta, Canada].
[
Insert additional description]
DESCRIPTION OF ROLE
____
__________________ [insert individual’s name] will be acting as a __________________ [insert individual’s role].
In this role, the individual will have access to vulnerable individuals.
[Insert additional information re: type and number of vulnerable individuals, frequency of access, etc.]
C
ONTACT INFORMATION
I
f more information is required from [Volleyball Alberta], please contact the Screening Committee Chair:
D
iane Bugler
Executive Director
Volleyball Alberta
Email: dbugler@volleyballalberta.ca
Tel.: 403-202-6540
S
igned: ____________________________ Date: ____________________________
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Appendix D Request For Vulnerable Sector Check (Volleyball Alberta)

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Completed 7 February 2021

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