VOLUNTEER APPLICATION FORM
Full Name________________________________
Phone Number email
_______________________________________________________
Home Address
____________________________________________________
City, State Zip
______________________________________ Yes or No _______________________
Employed By (If Employed) Other Retired
How long have you lived at this address? ________________________________
May you be called at work? {} Yes {} No
Number_______________________________
Brief description of volunteer experience?
Formal Education (highest year completed):
_____________________________
Do you speak a foreign language? {} Yes {} No If yes, which language
______________________________________
Do you drive? {}Yes {}No Do you have access to a good working vehicle that you would use to to get to and from locations with insurance {}YES or {}No
Current Community Involvement, if any.
Special Certification (i.e. CPR, Medical, etc.): q Yes q No
What type ____________________________________________________________________
Are you willing to commit to 3 6 or 12 months volunteer service? {}Yes Or {}No
Which length of time? _______________
What are your reasons for wanting to participate with our non-profit?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Can you consent to a routine background check? {}Yes Or {}No
Please list three references of people who know you well, other than relatives, preferably for whom you have worked in either a paid or volunteer capacity. If you are currently working, either paid or as a volunteer, please include the name of your supervisor.
Name Phone No. Relationship
- _________________________________________________________________________
- _________________________________________________________________________
- _________________________________________________________________________
All information obtained will be held in the strictest confidence.
_______________________________________ _____________________________________
Electronic Applicant Signature Date