Resident Application Form

Resident Intake Form

* Mandatory Fields

Residents eligible to receive this service (all options must apply):*

must reside in the City of Guelph in a single dwelling or semi-detached house with private driveway

are unable to remove their own snow and cannot afford to pay for snow removal

have no able-bodied person living in the household able to shovel snow

Residents eligible to receive this service must also (please select from the following options):*

be a senior citizen (aged 65 years of age or older)
have a physical disability

Name:*
Street Address:*
City:*
Postal Code:*
Phone Number:*
Email:

The Volunteer Centre of Guelph/Wellington reserves the right to ask for documentation verifying proof of disability and inability to pay for private snow removal service, in order to ensure services are provided to those in our community who truly require assistance. The Volunteer Centre may ask for the following documentation to be shown to a staff member only. No copy of this information will be collected, maintained or stored by the Volunteer Centre. All information provided to a Volunteer Centre staff member will be kept confidential and will not be requested for any reason other than for the purposes of administering this program.

Proof of disability: must be a recipient of support through one of the following programs, or a similar program: a) Ontario Disability Support Program (ODSP); b) Guaranteed Income Supplement (GIS) for low income seniors; c) Canada Pension Plan Disability (CPPD)

Proof of financial eligibility: the above or the individual must meet the low-income measures as published by Statistics Canada.

Date:* Name:*

Those wishing to support this program can make a donation to the Volunteer Centre of Guelph/Wellington, charitable #86895 0015 RR0001.

The Volunteer Centre of Guelph/Wellington is a nonprofit organization whose mission is to strengthen our communities through volunteerism an access to Community Information.