Volunteer Application

Name

First NameLast Name
Phone Number
Email
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address (If different than home address)

Address

Address Line 2

CityState / Province

Postal / Zip Code
Physical limitations:
ADA accessibility needs:
INTERESTS, SKILLS, EXPERIENCE, CERTIFICATIONS

Mark x in front of all you are able to do and/or willing to do.
Type a question

Answer phoneCollect and log class feesEnroll membersCount moneyFile documentsStuff envelopesEvent setup/teardownEvent staffingPick up/deliver itemsEmailTextPost on FacebookData entryData collectionMaintain spreadsheetsPlan eventsCommittee workOutbound phone callsOther
Type a question

Speak SpanishSpeak RussianSpeak other languageSmall flyer design (MS Word, Adobe CC, or other application)Writing/editingPhotograph events/peopleBooth staffingPublic speakingAccountingFirst aid certificationCPR certificationAED certificationFood handler permitOLCC server permitCDL driver permitPassenger endorsementHave a truck/pickupHave access to a trailer
CLASSES I WOULD BE WILLING TO TEACH
Describe:
PREVIOUS VOLUNTEER EXPERIENCES
Describe:
YES! I would like to volunteer for Silverton Area Seniors, Inc. I would prefer to volunteer as follows (Check all that apply.):
On a regular scheduleGive me a specific jobCall me when you need help
Once a weekTwice or more a weekOnce a month
Let us know which days and times you are available:
Monday

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Tuesday

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Wednesday

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Thursday

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Friday

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Saturday

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
I understand and accept the risks involved in volunteering and hereby release Silverton Area Seniors Inc. and all of its employees, elected representatives, and agents from liability, loss, claims or damages whatsover arising from my participation.
First NameLast Name
Date

MonthDayYear
Date
Should be Empty:

INTERESTS, SKILLS, EXPERIENCE, CERTIFICATIONS

CLASSES I WOULD BE WILLING TO TEACH

PREVIOUS VOLUNTEER EXPERIENCES