Volunteer Application

Name*

First NameLast Name
Street Address*
City*
State*
Zip*
Phone*
Date of Birth

MonthDayYear
Date
Email*
example@example.com
Emergency Contact
Name*
Phone*
Relationship*
Character References
Please provide the names and contact information of two character references:
Name*
Relationship*
Telephone*
Name*
Telephone*
Relationship*
Volunteer Positions
Some of the volunteer positions we offer. Please check the ones you would be most interested in.*

Peer companion (come in and hang out, have conversations meet great people)Sort donationsLaundry (towels and washcloths mainly)Teaching (financial education, employment related topics, benefits services, nutrition, how to use a computer, community resources, etc.Communications (Social media experience appreciated).Fundraising (may involve telephone calls, writing thank you notes, or grant writing).
List the skills you have, special interests or experience that you would like us to consider when placing you into an appropriate position?*
Please describe any physical limitations*
What days are you usually available?*

SundayMondayTuesdayWednesdayThursdayFridaySaturday
How many hours are you available per week?*
Do you prefer:*

MorningsAfternoonsEvenings
Signature
As a volunteer of Sheboygan Area Pay It Forward, I agree to abide by all policies and procedures as spelled out in the volunteer handbook. I understand that I volunteer at my own risk and neither the organization nor its employees assume any liability for any accidental injury or health problem arising from volunteer work I perform for the organization. I agree that all work I do is on a volunteer basis and I am not eligible to receive any monetary payment or reward.
Date*

MonthDayYear
Date
Print Name*
Should be Empty:

Emergency Contact

Character References

Volunteer Positions

Signature