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Volunteer Application Form

Name:
Address:
City, State, ZIP    
Best Phone Number to Use:
Best E-mail Address to Use:
Are you at least 18 years old? YesNo
How long have you lived in this area?
Current Occupation:
List any languages you are fluent in other than English:

Have you had previous volunteer experience?
If so, please describe with what organization(s) and in what capacity:

When are you available to volunteer? (check all that apply)
Weekday Mornings (list days avail.)
Weekday Afternoons (list days avail.)
On a sporadic basis

How often are you interested in volunteering?
Daily A few times per week Weekly
A few times per month Occasionally
When are you available to start?
What type of volunteer assignment are you interested in?
Do you have any physical limitations that would affect the type of volunteer work you could do?

How did you hear about our volunteering opportunities? (check all that apply)
Friend/Relative Work School
Church/Synagogue Newspaper Internet
Other

Please list two references we may contact:
REFERENCE 1:
Name:
Address:
Telephone:
Known how long?
In what capacity:
REFERENCE 2:
Name:
Address:
Telephone:
Known how long?
In what capacity:


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