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Volunteer Application

Your Info

First Name: Required

Last Name: Required

Email Address Required

Primary Phone: Required

Alternate Phone:

Location

Street Address 1: Required

Street Address 2:

Country: Required

State/Province: Required

City: Required

Zip/Postal Code: Required

Emergency Contact

Emergency Contact: Required

Emergency Contact's Phone: Required

Relationship: Required

Current Employer or School

Current Employer or School:

Does your employer have a volunteer matching program? Required
Yes No or N/A

Interest & Availability

Opportunity of interest (check all that apply) Required

Donation Center Volunteer

Donation Drive Host

Evening Shelter Volunteer

Shelter Meal Group Coordinator

Snack Pack Coordinator

Unsheltered Count

Other

Please provide a description on how you would like to become involved.

How often would you like to volunteer? Required

Daily

Weekly

Monthly

One Time

Other

Why are you interested in volunteering? Required

Days and times you are available to volunteer Required

Background & References

Do you have any special training or skills you would like to use in volunteering? Examples include but are not limited to foreign languages, artistic ability, teaching talents, etc. (Don't be modest!) Required

Have you ever utilized our services (Emergency Shelter, Kateri Residence, Programs to End Long Term Homelessness, Street Outreach, Job Room, EFS/MFIP) in the past? Required
Yes, in the past 2 years Yes, but not in the past 2 years No, never

Since some of our positions involve access to confidential information and/or contact with at-risk populations, a person's prior conviction(s) may be prohibitive to serving in some positions. Depending on the position(s) you are interested in, we may also pursue a background check later in the application process. If the background check shows information different than you have disclosed, we may choose to deny you placement as a volunteer with our organization. This is an opportunity for and a verification of openness and honesty, rather than an attempt to exclude people. Thank you for understanding.

Please disclose all misdemeanor and felony convictions in the last 10 years. Include year and state of conviction. Required

Reference #1 (Include contact information) Required

Reference #2 (Include contact information) Required

I certify that all information provided above is correct to the best of my knowledge. I also grant the Volunteer Coordinator permission to check provided references.

Yes, I do. Required

By submitting this form, you accept the Mollom privacy policy.