Hope House Volunteer Application

Name: *

Address: *

City: *

State: *

Zip: *

Home Phone: *

Work Phone:

May we call you at work?:

Email: *

Date of Birth:

Occupation:

Employer:

Business Address:

Educational Background:

Community Affiliations / Clubs:

Previous Volunteer Experience:

Skills, Special Interests:

In case of emergency, please contact:

Emergency Contact 1 (name, address, and phone number):

Emergency Contact 2 (name, address, and phone number):

Physician (name, address, and phone number):

Personal References, not relatives: (Please do not give a phone number. We do not call references.)

Personal Reference 1 (name, address, city, state, zip):

No relatives, please!

Personal Reference 2 (name, address, city, state, zip):

No relatives, please!

I ATTEST THAT THE ABOVE INFORMATION IS CORRECT AND ACCURATE.:

I authorize Hope House to contact the above individuals for a character reference.:

Are you interested in volunteer work that involves direct interaction with our clients or their children? (Direct service volunteers are required to complete an 40 hours of training.):

Yes

Maybe

Please describe your volunteer interest in more detail:

Approximately how many hours per week or month are you interested in volunteering?:

When are you available? :

Weekdays

Weekday evenings

Weekends

How did you hear about us?:

Are you interested in assisting with special events? This is a sporadic need and requires 8 hours of volunteer training.:

Are you interested in clerical work? The need is continuous, and does require 8 hours of volunteer training.:

PLEASE NOTE: A CRIMINAL RECORDS CHECK IS ROUTINELY PROCESSED WITH ALL VOLUNTEERS AS THEY COMPLETE OUR VOLUNTEER TRAINING PROGRAM. AT THAT TIME YOU WILL BE ASKED FOR $20.00 TO COVER THAT COST.

HopeHouse

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Hope House Volunteer Application

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