Volunteer Application Form

Please fill out the form below and submit.

General

Last Name

First Name

Middle Name

Address

City

State

Zip Code

Phone Number

Day Phone

Evening

Email & Date of Birth

Date of Birth

Volunteer Position Desired

Gift Shop Clerical

Hospitality Desk

Baby Cuddler

Other

Days/hours of week available

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Will you be available throughout the year?

Availablilty

If not, what month(s)

Employment or Volunteer Experience

Experience

Special Training Skills

Do you speak any languages other than English?

Other than English

Which ones

Please list two references other than family members

Reference - 1

Name

Address

Phone

Reference - 2

Name

Address

Phone

In case of an emergency, please list a contact person and their relationship to you

Name

Phone

Relationship

How did you hear about our Volunteer Services Program?

How did you hear about us

Do you have any allergies or health conditions? If so, please explain

Have any allergies?

If so, please explain

Health Insurance

Personal Physician

Name

Address

City

State

Signature (Please Draw Your Signature Below)

Date

Adult (18 Years of Age or Older)

18 Years of Age or Older?

Education (Select Year Completed)

High School

Years Completed

College

Years Completed

College Name

Occupation

Work Phone

Organization Affiliations

Affiliations - 1

Affiliation

Affiliations - 2

Affiliation

Affiliations - 3

Affiliation