subject_line
Volunteer Application
General Information
First Name
*
Last Name
*
Street Address
*
Address Line 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Phone Number
*
Email Address
*
Date of Birth
*
+
Volunteer Interest
Where did you learn about our volunteer opportunities?
*
What type of volunteer work are you interested in?
*
Meal Donor
Shelter Support
Outreach/Drop-In
Donation Drive
Life Skills
Office Support
Tutoring
Child Care
Safe Place
Special Events
Host Homes
Other
Area of special training or expertise:
Accounting
Cooking
Fundraising
Art
Crafts
Medical Training
Business
Data Entry
Marketing
Computer
Event Planning
Painting/Construction
Languages spoken:
Other skills, special training, or expertise:
*
Gender
Male
Female
Volunteer Experience/Skills
Please list all organizations you have volunteered with and a brief description of your volunteer role.
Organization
Volunteer Role
Duties
1
Organization
Volunteer Role
Duties
2
Organization
Volunteer Role
Duties
3
Organization
Volunteer Role
Duties
4
Organization
Volunteer Role
Duties
Groups or organizations with which you are affiliated:
*
Work Experience
Are you currently employed?
*
Yes
No
Please list your employment history and a brief description of your position/duties.
Employer Name & Address
Dates
Position/Duties
1
Employer Name & Address
Dates
Position/Duties
2
Employer Name & Address
Dates
Position/Duties
3
Employer Name & Address
Dates
Position/Duties
4
Employer Name & Address
Dates
Position/Duties
Are you an active duty or retired military veteran?
*
Yes
No
Availability
How often do you envision contributing as a volunteer?
*
Weekly
Monthly
On-Call
One Time
Availability and preference:
Available (Yes/No)
Times Available
Preference (1st, 2nd, 3rd)
Sunday
Available (Yes/No)
Times Available
Preference (1st, 2nd, 3rd)
Monday
Available (Yes/No)
Times Available
Preference (1st, 2nd, 3rd)
Tuesday
Available (Yes/No)
Times Available
Preference (1st, 2nd, 3rd)
Wednesday
Available (Yes/No)
Times Available
Preference (1st, 2nd, 3rd)
Thursday
Available (Yes/No)
Times Available
Preference (1st, 2nd, 3rd)
Friday
Available (Yes/No)
Times Available
Preference (1st, 2nd, 3rd)
Saturday
Available (Yes/No)
Times Available
Preference (1st, 2nd, 3rd)
References
Please list three references we may contact.
Name
Relationship
Phone Number
1
Name
Relationship
Phone Number
2
Name
Relationship
Phone Number
3
Name
Relationship
Phone Number
Emergency Contact Information
Emergency Contact Name
*
Emergency Contact Relationship
*
Emergency Contact Phone Number
*
Background Check
Under state regulations, we are required to run a complete criminal background check. Please sign here representing your acceptance of this procedure:
*
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Organization Communications
Would you like to receive our quarterly newsletter?
*
Yes
No
Would you like to receive our monthly e-newsletter?
*
Yes
No
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