Volunteer Application
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
I am seeking this volunteer position to:
Satisfy a school/class/scholarship requirement
Satisfy mandated community service reqiurements
Become a regular volunteer with the agency
Other
How many hours are you required to complete?
Date the you must complete the requirement by:
If there is no requirement date, please respond "N/A"
Referral Source
Community Member
Online Source
Agency Website
Social Media
Newspaper
Other
Demographics
The following questions are Optional. The following questions help us track demographic data; this information is not used for screening or placement.
Are you over the age of 18 years old?
Yes
No
What is your age?
Please check all that apply:
Senior Citizen
Adult
College Student
High School Student
Middle School Student
Does your household identify as low income?
Yes
No
Please check off the skills, abilities, or interests that are applicable to you:
Typing/Word processing
Data processing/computer work
Bulk mail help (envelope stuffing, folding)
Maintenance (painting, landscaping, carpentry, cleaning)
Grant writing/marketing/graphic design
Program/project/event help
Food handling/stocking shelves
Knowledge of a foreign language
Other
Please list any special interests, skills, or hobbies"
Please list any work/activity you must avoid due to physical limitations or health concerns:
Our regular operating hours are Monday through Friday from 8am to 4pm. Are you available to volunteer during our regular operating hours
Yes
No
Other
Please provide your availability.
Please provide an emergency contact.
Rows
Name
Relationship
Phone Number
Contact 1
Do you have reliable transportation?
Date
-
Month
-
Day
Year
Date
Please upload your resume or other relevant documents.
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VOLUNTEER!
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