General Volunteer Application

General Volunteer Application
Name*

First NameLast Name
Date of Birth *

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Organization (if necessary)
Is this for court mandated community service hours?
If you stated yes on the previous question please describe the offense:
Day(s) Available to Volunteer

SundayMondayTuesdayWednesdayThursdayFridaySaturdayVaries by Week
Date(s) to Volunteer:*
Time(s) to Volunteer:*

Morning 9:00am - 12:00pmAfternoon 12:00pm - 4:00pmEvening 4:00pm - 7:00pm
Volunteer Duties to Perform

General Volunteer DutiesHousekeeping and CleaningClerical and AdminYardwork/LandscapingGuest Transportation (additional info required)Guest InteractionMeal Preparation and ServingBoard of Directors Application/Interview (additional info required)
Volunteer Duties to Perform:*
Message/Notes:
By clicking the "Submit" button below, I hereby acknowledge that I have read and completely understand the Samaritan House Volunteer Policy.
Please verify that you are human*
Date

MonthDayYear
Date
Should be Empty: