Volunteer Form
Full Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Best time/s to call
Hour Minutes
AM
PM
AM/PM Option
Until
until
Hour Minutes
AM
PM
AM/PM Option
Employer
Occupation
Skills and Interests
Major area of study or area of special training
Hobbies, Skills and Special Interests
Tell us a little about you
How did you hear about us?
Friend/Family Member
Radio
T.V.
Our Website
Other
What type of volunteer work interests you? (Check all that apply)
Collecting Christmas gifts
Helping in the shelter
Meal Provider (once a month)
Working one-on-one with an individual
Helping with Holiday projects (dinners, wrapping gifts)
Sharing a skill or talent
Other
What is the special skill?
Availability
When is best for you to volunteer?
I am flexible
Prefer weekends
Prefer weekdays
Prefer evenings
Other
How often would you like to volunteer?
Weekly
Occasionally
Monthly
Other
Background Information
Have you ever been convicted of a criminal offense?
*
Yes
No
If yes, please explain
If you have a disability, please list any accommodations you may need to volunteer
Previous/Current Volunteers Experience
Name of Company
Supervisor
Phone #/Email
Start and End Dates
1
2
3
Please rate yourself in the following 5 areas honestly. This will help us with training and placing you.
*
Rarely
Sometimes
Often
Always
Not Sure
I handle verbal confrontations well.
I am good at expressing my thoughts verbally.
I work well with the opposite sex.
I am a good listener.
I work well in a group or on a team.
I verify that all of the above information is true. Any discrepancies in the above info may be grounds for denying or terminating my volunteer placement. I also understand that by submitting this application, I authorize inquires to be made concerning my suitability as a volunteer. The information requested in this application, and such as may otherwise be obtained will be used only for the purpose of determining suitability as a volunteer. All information will be held in confidence. I acknowledge and agree that I am not obligated, if called upon, to perform any volunteer services for the agency and that agency is not obligated to assign volunteer services. A copy of this application will be sent to the program I wish to volunteer with. I understand that the agency has sole discretion in determining suitability.*
Volunteer's Signature
*
Date
*
-
Month
-
Day
Year
Date
* Your age will not be used to determine suitability expect when licensing codes are applicable.
Continue
Continue
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