Volunteer Application


Contact Information




Street Address


City ST ZIP Code


Home Phone


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





___Phone bank

___Field work

___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


Alternate 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.