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Volunteer Application

Our organization encourages the participation 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

Personal Information

Name(Required)

First Last

Date of Birth(Required)

MM slash DD slash YYYY

Address(Required)

Street Address Address Line 2 City State ZIP Code

Home Phone

Cell Phone

Work Phone

Email

Preferred Method of Contact(Required)

Home

Cell

Email

Have you ever worked for this company?(Required)

Yes

No

Have you ever been convicted of a felony?(Required)

Yes

No

If yes, please explain:

Please list three professional or personal references.

Full Name:(Required)

Relationship:(Required)

Company:(Required)

Phone:(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Full Name:(Required)

Relationship:(Required)

Company:(Required)

Phone:(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Full Name:(Required)

Relationship:(Required)

Company:(Required)

Phone:(Required)

Address:(Required)

Please indicate days available:

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Times Available:

Any physical limitations?(Required)

Yes

No

If yes, please explain.

Current place of employment

Occupation

Referred by:

OTHER WORK EXPERIENCE (include paid and volunteer)

EDUCATION (include continuing education or special training)

SPECIAL SKILLS

Emergency Contact(Required)

As a volunteer of our organization I 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 affiliates, 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 and I am not eligible to receive any monetary payment or reward.

Signature(Required)

(410) 219-5070

[email protected]

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