Volunteer Application

Volunteer Application

This is the volunteer application for Fairview Haven. Please complete the contact information, experience, availability, volunteer interests, and consent sections below. We appreciate your interest in serving our community!
First Name
M.I.
Last Name
Birthday

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Street Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
What are the most effective ways to contact you?
Emergency Contact Information
Emergency Contact

First NameLast Name
Relationship to You
Emergency Contact Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Reference

Please provide the contact information of a personal or professional reference (other than relatives or family members) who have known you for at least one year.
Name

First NameLast Name
Relationship to You
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Current Volunteer Status
Please specify:
If you are currently volunteering at Fairview Haven, please specify how you are volunteering below:
School Credit

If your volunteer service is for school credit, please fill out the section below.
School Name
School Address
Course Title
Course Requirement
Contact's Name
Contact's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Contact's Email
example@example.com
Experience, Interests, Skills
Volunteer Experience
Hobbies & Interests
Skills & Abilities
Musical, clerical, computer, painting, etc.
Availability
Preferred scheduling option
If regularly scheduled, how often?

Availability by day and time

Rows	Morning	Afternoon	Evening	Specific hours
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Types of Volunteer Work
Please check everything you would be interested in.
Maintenance
Housekeeping
Transportation
Dining Services
Business
Laundry
Entertainment
Resident Visits
Activities
Other
What would be your top choices of volunteer work?
Events

If you would be interested in helping with events, please review the list below and select the ones you are interested in.
Events of Interest
Volunteer Consent
Notes
Is there anything you feel we need to know about you or your preferences?
I understand that if accepted as a volunteer:
- I voluntarily offer my services with the understanding there will be no monetary compensation.
- I agree to conform to all policies, procedures, and regulations.
- I will satisfy any health screening requirements.
- If requested, I will submit references and/or submit to a background check.
- I certify that the information contained in this questionnaire is correct to the best of my knowledge.
Please sign below:
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parent Signature

(required if age 17 or under)
Date

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

Volunteer Application

Emergency Contact Information

Reference

Current Volunteer Status

School Credit

Experience, Interests, Skills

Availability

Types of Volunteer Work

Events

Volunteer Consent