Volunteer Application

Contact Information
Street Address*
City ST ZIP Code*
Work Phone
E-Mail Address*
During which hours are you available for volunteer assignments?
Weekday mornings  Weekend mornings 
Weekday afternoons  Weekend afternoons    
Weekday evenings   Weekend evenings  
Tell us in which areas you are interested in volunteering
Field work 
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
Street Address
City ST ZIP Code
Home Phone*
Work Phone
E-Mail Address
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 (printed)
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.