Volunteer Application

Contact Information
Name

Street Address

City ST Zip Code

Home Phone

Work Phone

Availability
During which hours are you available for volunteer assignments?
Weekday Mornings
Weekday Afternoons
Weekday Evenings
Weekend Mornings
Weekend Afternoons
Weekend Evenings

Interests

Tell us in which areas you are interested in volunteering
Administration
Events
Field work
Fundraising
Deliveries
Phone bank
Newsletter production
Volunteer coordination

Special Skills or Qualifications
Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.

Previous Volunteer Experience
Summarize your previous volunteer experience.

Person to Notify in Case of Emergency
Name

Street Address

City ST Zip Code

Home Phone

Work Phone

Agreement and Signature
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.
Name

Signature

Date

Our Policy
It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability. Thank you for completing this application form and for your interest in volunteering with us.