JW House Volunteer Application

Weekly House Volunteer Application

JW House keeps families together by offering a welcoming home close to Silicon Valley hospitals, with a caring and compassionate environment that inspires hope. With a small staff, House operations are primarily run by weekly volunteers - from greeting guests, giving tours, setting up for meals, light food preparation when necessary, and light cleaning. It is a truly rewarding experience to be able to support adults and children who are going through a difficult time, and provide them with the comforts of home.
Please fill out the application below if you are interesting in becoming a House Volunteer. Weekly volunteers are scheduled for one 3-4 hour shift (of the same time) each week and must be able to commit to at least six months of service.

On-call shifts are also available if you cannot make a regular weekly commitment.

We encourage our on-call volunteers to pick up 2-3 shifts per month.

**You must be 18 years or older to serve as a volunteer.
Personal Information
First Name:
Last Name:
City:
State:
Phone Number:
Email:
example@example.com
How did you hear about JW House?
Background
Are you currently employed?
Current or Previous Employer (optional):
Occupation (optional):
Volunteer Experience
Organization:
Role:
Is this a current role?
Date: from

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Date: to

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Organization:
Role:
Is this a current role?
Date: from

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Date: to

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Community Affiliations:
Skills, Interests, and Hobbies:
What volunteer opportunities are you interested in?
Availability

Please indicate your general availabilities for volunteering on a weekly basis - check as many blocks as your schedule permits. A specific day and time for your chosen assignment will be discussed during your interview.

Rows	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Morning (9:30am-12:30pm)
Afternoon (12:30pm-4:00pm)
Evening (4:00pm-7:15pm)

Language Proficiencies

Enter any languages you read, write, or speak (other than English).
Language:
Fluency:
References

List two individuals not related to you and that you have known at least one year.
Name:
Relationship:
Email
example@example.com
Phone Number:
Relationship:
Name:
Email
example@example.com
Phone Number:
Criminal Background Information

In answering the following questions, do not disclose misdemeanor marijuana-related convictions that are more than two years old; convictions that have been expunged, sealed, or statutorily eradicated; misdemeanor convictions for which probation has been successfully completed or discharged and the case has been judicially dismissed; or any referrals to a pre-trial or post-trial diversion program.
Have you ever been convicted of or pled guilty to a felony?
Have you ever been convicted of or pled guilty to a misdemeanor that might be related in some way to the position for which you are applying (including convictions such as those relating to honesty, integrity, or illegal use of drugs)?
If you answered “Yes” to either of these two questions regarding convictions, please describe the convictions(s) in detail, including dates:
Agreement
Digital Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Weekly House Volunteer Application

Personal Information

Background

Volunteer Experience

Availability

Language Proficiencies

References

Criminal Background Information

Agreement