Volunteer Application

General Information

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

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? *

Area of special training or expertise:

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: *

clear

Organization Communications

Would you like to receive our quarterly newsletter? *

Yes

No

Would you like to receive our monthly e-newsletter? *

Yes

No

Meal Donor	Shelter Support	Outreach/Drop-In
Donation Drive	Life Skills	Office Support
Tutoring	Child Care	Safe Place
Special Events	Host Homes	Other

Accounting	Cooking	Fundraising
Art	Crafts	Medical Training
Business	Data Entry	Marketing
Computer	Event Planning	Painting/Construction