Volunteer Application

VOLUNTEER INFORMATION

Name*:
Phone (primary)*:
Phone (work):
Phone (cell):
Email*:
Birth Date (mm/dd/yy)*:

ADDRESS

Street*:
City*:
State*:
Zip*:
How long have you lived at your current address?*:
PREVIOUS ADDRESS
Street:
City:
State:
Zip:
How long did you live at previous address?:

EMERGENCY CONTACT

Emergency Contact Name*:
Emergency Contact Phone*:
Emergency Contact Relationship*:

EDUCATION

High School*:
College:
Vocational/Technical School:

WORK EXPERIENCE

Work Experience*:

VOLUNTEER EXPERIENCE

Current Volunteer Experience:
Previous Volunteer Experience:
Do you know anyone working at St. Anne's?*:
If yes, what is their name:

PERSONAL REFERENCES

Reference #1 - Name*:
Reference #1 - Phone*:
Reference #1 - Address*:
Reference #2 - Name*:
Reference #2 - Phone*:
Reference #2 - Address*:
Reference #3 - Name*:
Reference #3 - Phone*:
Reference #3 - Address*:

ABOUT YOU

Hobbies, Skills & Special Interests*:

Where Would You Like to Volunteer?

When Can You Volunteer

Please Note: Sunday volunteer hours are only available for Gift Shop and Good Samaritan volunteers.
My Comittment Will Be*:
Do you need any accommodations to do the volunteer tasks selected?*:
Please Note: The Volunteer Coordinator will have a conference with you concerning your needs for accommodation.
Why you are interested in volunteering at St. Anne's?*:
Church Affiliation (optional):
Additional Information, Questions or Comments:

AGREEMENT

Before volunteers are accepted, they will be required to have a criminal background check completed by the volunteer (form provided). They will also need a negative PPD test for tuberculosis – administered by St. Anne’s at no charge).I give permission to St. Anne’s to contact any listed person, school, business or volunteer places of services as reference sources and conductthe required criminal background investigation. I also give permission for my phone number and email to be utilized by St. Anne’s including theAuxiliary, for the purpose of volunteering and fundraising events.
By checking this box, I acknowledge I have read the agreement above: