POL CARE Volunteer Form

Volunteer Application

Our organizaton encourages the partcipation of volunteers who support our mission. If you agree with our mission and are willing to be interviewed and trained in our procedures, we encourage you to complete this application. The information on this form will be kept confidential and will help us find the most satisfying and appropriate volunteer opportunity for you.
Thank you for your interest in our organization.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Employer
Position
Any special talents or skills you have that you feel would benefit our organization?
AdministrationEventsProgramsFundraisingDeliveriesCommunicationCampaignOther
MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Time Available*

:HourMinutesAM/PM Option
Until
until :HourMinutesAM/PM Option
Any Physical Limitations
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*

Area CodePhone Number
As a volunteer of our organization, l agree to abide by the policies and procedures. I understand that I will be volunteering at my own risk and that the organization, its employees and afiliates, cannot assume any responsibility for any liability for any accident, injury or health problem which may arise from any volunteer work I perform for the organization. I agree that all the work I do is on a volunteer basis.
Initials*
Should be Empty:

Volunteer Application