Raphael House Volunteer Application and Agreement

Title

Dr., Mr., Mrs., Ms., etc

Name*

First NameLast Name

Date of Birth*

MonthDayYear

E-mail*

Phone Number

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Long-term and as-needed individual volunteer roles at Raphael House are limited.

Please note, we are not actively recruiting volunteers for any individual volunteer roles. We will keep applications on file and reach out in the future if a need arises that matches your interests.

Please select any areas below in which you would be willing to donate your time or skills on a regular, weekly basis. These roles require a live scan fingerprinting background check. We ask regular volunteers to commit to volunteering for at least 6 months- 1 year to maintain consistancy for the children and families in our programs.

Long-Term, Regular Volunteer Roles:

Children or Family Activity Assistant, one weeknight per week ~ 6:30 -7:30 pmAcademic Tutoring (K-12) - likely remote, over Zoom, timing varies

Please select any areas below in which you would be willing to donate your time or skills on an as needed basis. These roles do not require a weekly commitment.

As Needed Volunteer Roles:

Pro Bono Professional Services (Finance, Graphic Design, Web Development, Marketing, etc)Fundraising events (Raphael House Gala, etc)Contact me about opportunities to volunteer with my family (including young children)

If you selected "Pro Bono Professional Services", please provide specifics on what service you are interested in offering:

Occupation

Are you currently employed?*

YesNo

Name of Your Present or Most Recent Employer*

Job Title

Are you a student?*

YesNo

Name of school

Major

What motivated you to want to volunteer at Raphael House?

Do you have special interests or life experiences that would contribute to the work we do?

Are there any languages other than English that you speak fluently?

Have you ever lived in Raphael House’s Residential Shelter or received services from Raphael House? *

If you answered yes to the question above, has it been three or more years since you last received services?

Please answer the following questions. Your responses will be kept confidential:

Have you ever been convicted of, or pleaded guilty to, a crime?*

YesNo

Are you currently under arrest, or released on bond or on your own recognizance, pending trial for a criminal offense?*

YesNo

If you answered yes to either of the above, please state the circumstances:

Areas of Interest

Experience & Skills

Background