Either print and complete the following form Volunteer Companion Visiting Form (PDF) and return to us via mail or fill out the electronic form below.

Saanich Volunteer Services Society
1445 Ocean View Road Victoria, BC V8P 1J8
Telephone 250-595-8008 Fax 250-595-8005
Email: contactus@saanichvolunteers.org

Name
Date(s) of Visit(s)	]
Hours spent attending Support/Educational Meetings:
Partners Name:
Number of visits in person with your partner:
Hours Spent Visiting Your Partner:
Number of Kilometers driven while visiting:
Bus trips	---Adult One ZoneAdult Two ZoneSenior One ZoneSenior Two Zone
Number of telephone calls
Time (hours) spent on the phone with your partner
Total hours spent with your partner
Comments

It is necessary for us to keep statistics regarding volunteer hours for funding purposes.  Please complete this sheet and email to the office within a week of the month’s end.  We really appreciate it.