Volunteer Application Form for Non-Profit

Volunteer Interest Form

Submit the completed form, and we will contact you soon. Thank you for your interest in serving at City of Refuge Dalton!
Since its inception in 1995, City of Refuge has consistently worked to meet the basic needs of children, families, individuals, and senior adults in the community with the goal of equipping them to improve their current situations. Through partnerships with local schools, businesses, churches and individuals, City of Refuge Dalton continues to reach people who need a hand up. We help them reclaim their sense of life direction and set them on a path to repurpose their giftings and abilities. City of Refuge Dalton is a place of opportunities where people can find transformation and hope.
Name

PrefixFirst NameLast Name
Birth Date

MonthDayYear
Email
example@example.com
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Select Best Ways to Contact

CallTextEmail
Educational Background
Occupation
In which areas would you like to volunteer?
Do you have any volunteering experience? If yes, please describe.
What skills and abilities do you have? ex. carpentry, computer, clerical, ...
GROUP Interest

I would like to bring a group to serve at CORD.
Internship

I am interested in a volunteer internship.
BACKGROUND and VOLUNTEER AGREEMENT

Have you ever been convicted (found guilty) of a crime (including probations before judgment), or are there any pending criminal charges awaiting a hearing in a court of law? Do not list any criminal charges for which records have been expunged.
If you answered yes, please describe all convictions, when they occurred, the circumstances involved, and any rehabilitation.
Explain Legal Background
If you are part of a mandated community service program, please provider the name of your community service officer First Name Last Name and a contact phone numberArea Code Phone Number .
Do you have any physical or other limitations which might limit your ability to perform certain types of work? Please explain.
Emergency Contact (Type Name and Phone Number)
Statement of Acknowledgement: I certify by my submission of this form that all information is true and has been given voluntarily. I release the agency from any liability and allow them to verify this information through any party with legal and proper interest. As a volunteer at City of Refuge Dalton, I agree to serve in a way that honors City of Refuge Dalton and others as well as honoring the confidentiality of those we serve. As a volunteer, I agree to share my likeness through photos and videos in promotional material used by City of Refuge Dalton, unless otherwise indicated. Upon serving in select volunteer positions, I understand that I may be required to provide additional information or complete a background check.
By signing your name, you are acknowledging the above statement.
Date

MonthDayYear
Date
Signature
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Volunteer Interest Form