Volunteer Application
Fields marked with * are required.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
Date Picker Icon
Have you ever been convicted of a crime? If yes, please explain.
*
Have you ever been or are you currently employed at Oaklawn?
*
Yes
No
High School Information
*
School Name
City/State
Diploma Received
Diploma Received
College Information
School Name
City/State
Degree Received
Degree Received
Why would you like to volunteer at Oaklawn?
*
How many hours a week are you available?
*
What campus would you like to volunteer with?
*
Goshen
Elkhart
Mishawaka
South Bend
Emergency Contact Information
*
First Name
Last Name
Emergency Contact's Relationship to you:
*
Emergency Contact's Phone Number
*
-
Area Code
Phone Number
Reference 1 Information
*
First Name
Last Name
Reference 1 Email
*
example@example.com
Reference 1 Relationship to you
*
Reference 2 Information:
*
First Name
Last Name
Reference 2 Email
*
example@example.com
Reference 2 Relationship to you
*
In accordance with Oaklawn Policy it is standard procedure to perform a background check, including criminal and drug/alcohol testing prior to establishing a volunteer, mentor or tutor position.
*
I agree to such checks
I do not agree to such checks
I certify that all information I have provided is true,complete and correct. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect will be sufficient cause to cancel further consideration or immediately discharge me from a volunteer position whenever it is discovered. I authorize Oaklawn, its representatives, employees or agents to contact and obtain information from all references (personal and professional) to verify the accuracy of all information provided by me.
*
I agree
I do not agree
Submit
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