SAMPLE VOLUNTEER APPLICATION FORM (volunteer position …
SAMPLE VOLUNTEER APPLICATION FORM
_______________________________________________________
(volunteer position title)
SECTION I
Date _____________________
Name ___________________________________________________________________________
Address _______________________________________ City _____________ State _____ Zip ________
Home Phone:_________________ Work Phone:____________ E-mail: _______________________
SECTION II Previous Volunteer Experience ____________________________________________________________ _____________________________________________________________________________________ Occupation (Past occupation if retired): ________________________________________________________ Other information that will help us make a good match (such as education, general interests/hobbies) __________ _____________________________________________________________________________________ _____________________________________________________________________________________ Languages Spoken: _____________________________________________________________________
SECTION III Availability and Volunteer Assignment Preferences
Please Check All That Are Applicable:
I Am Available
Mornings (Mon-Fri) Weekends One Time Only
Afternoons (Mon-Fri) Once A Week As Needed
I Could Serve More Than One Person:
Yes
No
Evenings (Mon-Fri) More Than Once A Week OTHER
SECTION IV
Do You Have A Valid (State) Driver's License?
Yes
No
License Number: ________________ Vehicle License Plate Number ____________________
Insurance Company: _____________________________ Policy #:_______________________
Have You Ever Been Convicted For Violation Of Any Laws, Traffic Or Otherwise?
Yes
No
If Yes, Please Explain: __________________________________________________________________
Do You Have Any Physical Condition that May Limit Your Activities?
Yes
No
If Yes, Describe: _______________________________________________________________________
Who To Notify In Case Of An Emergency? __________________________________________________ Telephone Number: _____________________________
SECTION V [ References ] Please list three persons we may call who are NOT family, one of whom may be your religious or spiritual leader, teacher, employer or relationship other than personal friend.
Name ____________________________________________________ Phone ______________________ Address _______________________________________________________________________________ Relationship ___________________________________
Name ____________________________________________________ Phone ______________________ Address _______________________________________________________________________________ Relationship ___________________________________
Name ____________________________________________________ Phone ______________________ Address _______________________________________________________________________________ Relationship ___________________________________
Comments:
I hereby give my consent to contact my references; to contact my employers, past and present; and to conduct a background check.
_____________________________________
Signature Of Applicant
_________________
Date
Adapted from Tools for Success ? Volunteer Management Guide ? NFIVC - 1997
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