SFH Volunteer Application

St. Francis House Volunteer Application
General Information
Name*

First NameLast Name
Nick Name
Today's Date*

MonthDayYear
Date
Contact Phone*
Alternate Phone
Email Address*
example@example.com
Mailing Address
Birthday*

MonthDayYear
Date
Are you over 18?*
Best form of contact
Education, Employment & Experience
Highest Grade Completed?*
or GED?
College
Course of Study
Other Formal Education/Training
Current Employer*
Job Title*
Please list volunteer experience (current or previous) including organization name, duration & duties*
How did you learn about St. Francis House and our Volunteer Program?*
Are you interested in a long term commitment or a short term commitment?*
Will you be receiving class credit for volunteer hours served?*
Will you be receiving credit at work for volunteer hours served?*
Will you be receiving community service credit (for either court ordered or for welfare) for volunteer hours served? *
Is there a specific volunteer opportunity that you are interested in?*
Availability

Availability: We ask that volunteers be scheduled in 2-hour or 4-hour blocks, so please provide the hours that you are available to volunteer. Give a few options so that we can best schedule you. (example: Mondays 8am - 12pm, Mondays 12pm - 2pm, Thursdays 10am - 2pm, etc.)*

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
8am - 10am
10 am - 12pm
12pm - 2pm

History
Have you ever been convicted of a crime against a family or child?*
In Case of Emergency Contact (required):
Name (First & Last)*
Relationship*
Phone*
Address

Street Address

Street Address Line 2

CityState

Zip
Media Agreement
Media Release Agreement (check box if agree):I do hereby give my permission for my image and images of my children, but not my/their names, to be used in all media associations with the St. Francis House. All media statements and photos are used to make the community more aware of the needs, services, and people who seek shelter and help through the St. Francis House. The media releases are used to promote new interest, donations, and volunteering throughout the community and to help improve the programs and services of those in need.*

Type option 1
Signature

I agree that all the information I provided is correct and to the best of my knowledge.
Signature*

Clear
Date*

MonthDayYear
Date
Parent Signature (if under 18 years of age)

Clear
Date

MonthDayYear
Date
Print Parent Name
Should be Empty:

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General Information

Education, Employment & Experience

Availability

History

In Case of Emergency Contact (required):

Media Agreement

Signature