Volunteer Application Form

Personal Information

Maggie's Wigs 4 Kids of Michigan appreciates the support of great volunteers who donate their time, talent and treasure to assist our program. Please complete the application below with your information - we will follow up with you to schedule a time to volunteer.

First, Middle & Last Name*

Date*

Address*

City, State, Zip Code*

Email Address*

Phone Number*

Driver's License #*

Date of Birth*

Emergency Contact*

Phone*

We conduct criminal background checks. Have you been convicted of a crime (anything other than a minor traffic violation) within the last 10 years?*

YesNo

What is the nature of the offense and is this your first offense?*

How many hours do you need and what date do you need them by?*

Are there any felony charges pending against you?*

YesNo

Do you have your own transportation?*

YesNo

Experience

Education History*

Current Employer*

Volunteer History*

What personal or professional skills, experiences or resources would you offer to us as a volunteer?*

Volunteer Information

How did you find out about Maggie's Wigs 4 Kids of Michigan?*

What do you expect from your volunteer experience?*

What kind of time commitment can you make? Please list specific days & times.*

References

Please list three references complete with addresses. They can be from paid employment or volunteer work. Please do not list relatives (unless you are under the age of 18).

Name*

Relationship*

Phone*

Name*

Relationship*

Phone*

Name*

Relationship*

Phone*

Please complete the following:

I agree to have Maggie's Wigs 4 Kids of Michigan Wellness Center and Salon verify any information included on my application form; this may be done through a background check. Maggie's Wigs 4 Kids of Michigan may also conduct additional investigations as indicated. I hereby waive any rights to bring action for defamation, invasion of privacy, or any similar cause against Maggie's Wigs 4 Kids of Michigan. I understand that misrepresentation or omission of facts called for is cause for removal from the Volunteer Program.

Agreement:*

Yes

I agree to observe the following rules and regulations for the duration of my volunteer work at Maggie's Wigs 4 Kids of Michigan Wellness Center and Salon and after I have ended my association as a volunteer.

Agreement:*

Yes

No information regarding specific participants, i.e. names, addresses, etc., is to be divulged by me at any time for any reason except where required by policy and only under the directive of my supervisor.

Agreement:*

Yes

No information that could result in the misuse of Maggie's Wigs 4 Kids of Michigan program is to be divulged by me at any time for any reason.

Agreement:*

Yes

I acknowledge that I understand and agree to follow the above rules and regulations.

Volunteer Signature*

Date*

If applicant is under 18 years of age, please complete the following:

Parent Signature giving permission for child/teen to volunteer with Maggie's Wigs 4 Kids of Michigan