VOLUNTEER APPLICATION FORM
The following information will help us understand your interests and the resources
which you bring to volunteer work, and enable us to make plans that will ensure the
most satisfying experience for you as a volunteer. Thank you.
First Name:
__________________ Last Name: ___________________ M/F: _____
Address: ______________________________________________________________
Street
City
State
Zip
Home Phone: ________________________
Work Phone: _____________________
Email: ________________________ Cell Phone: ______________________________
Emergency Contact:_______________________________ Phone:________________
TIME YOU HAVE AVAILABLE FOR VOLUNTEER WORK:
Hours per week or month: ________________________________________________
Any preferred days or hours? ______________________________________________
How much advance notice would you usually need? ___________________________
Do you have a car and can you show proof of insurance? Y/N______ Would you be
willing to drive it to transport Stephen’s Place residents as part of your volunteer work?
Yes: _____ No: _____
Uncertain: _____
ARE YOU PRESENTLY EMPLOYED? _________
If yes, hours per week: _____
WORK EXPERIENCE: __________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
PRIOR EXPERIENCE AS A VOLUNTEER OR IN COMMUNITY ACTIVITIES:
_____________________________________________________________________
_____________________________________________________________________
VOLUNTEER APPLICATION FORM
Use only as authorized by
Stephen’s Place 2-15
1
initials _____