Event Coverage Request Form

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Please complete this request form as accurately as possible. In order for our volunteers to be effective in providing this service, we request as much information as possible about your event.

We also require at least three weeks notice prior to the day of the event.

Due to the amount of requests that St. John Ambulance receives, completing the form below does not guarantee that volunteers will be present at your event. Please note that if your event passes over a mealtime, food needs to be provided for our volunteers. When providing a donation, please include the cost of gas to get to your event.

Required Fields (*).

PLEASE NOTE:
SHANE(TYLER) SAVAGE IS NOT AFFILIATED WITH THE ST. JOHN AMBULANCE LEEDS, GRENVILLE & LANARK BRANCH.
For inquires for Community Services please contact Debbie Coligan at send2debbie@gmail.com or contact our Office Manager at 613-342-2974.

Agency Organization Information
Event / Coverage Information
Day 1
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Day 2
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Day 3
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Event Logistics
Are you be able to provide the following for our volunteers in order for us to be prepared to serve your participants and be equipped to handle a variety of situations.
If you said yes to a donation and you would like a reciept for it please fill out the fields below

Contact Us

St. John Ambulance Leeds, Grenville & Lanark Branch
St. John House
23 Abbott St,
Brockville, Ontario K6V 4A5
Phone613-342-2974Fax613-342-1483
Faxbrockville@on.sja.ca

Members