West Island Cancer Wellness Centre

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2008-2009

Professional Application

The WICWC seeks to provide a range of professional wellness services to support those affected by cancer. If you are a professional working in an area related to health and wellness, and you are interested in offering your services to the centre, please fill out the on-line application below.

It is important that you complete all fields of the application, indicating your area of specialty, references, and full contact information.

All applicants will be screened by a team of professionals.

Thank you for your interest in making the West Island Cancer Wellness Centre the place for people to turn when cancer affect their life!

General Information:
Name:
Street Address:
City:
Postal /Zip Code:
Province/State:
Phone number:
Email address:

Professional Information:
Occupation:
Credentials:
School:
Do you have Professional Liability Insurance?	YES NO
Working language:
Number of years working in this field:
Clientele (age, any specialties):

Any experience working with cancer patients?	YES NO
If YES, please describe:


Your desired relationship to the WICWC:
Would you be interested in working as a volunteer?	YES NO MAYBE

Please explain (include availability, fee for services (if any), what you would like to offer etc.)


References:

Name:
Street Address:
City:
Postal /Zip Code:
Province/State:
Phone number:
Email address:
How do you know this referee?:

Name:
Street Address:
City:
Postal /Zip Code:
Province/State:
Phone number:
Email address:
How do you know this referee?:

Name:
Street Address:
City:
Postal /Zip Code:
Province/State:
Phone number:
Email address:
How do you know this referee?:

Thank you for your interest in the
West Island Cancer Wellness Centre

Sep - 2010

L/M	M/T	M/W	J/T	V/F	S/S	D/S
30	31	1	2	3	4	5
6	7	8	9	10	11	12
13	14	15	16	17	18	19
20	21	22	23	24	25	26
27	28	29	30	1	2	3

Click here to download current calendar (.pdf)

OUR LATEST NEWS

Applications from
Health and Wellness Professionals are now being accepted
APPLY HERE.

CTV Power of One highlights WICWC

2nd Annual WICWC Golf Tournament
Monday, September 20, 2010
Registration is now open!
Read all about our tournament and register online to play and/or sponsor at:
http://2010wicwcgolf.webs.com/
We hope you can join us!