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Volunteer Application
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*
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Last
Address
*
Street Address
Address Line 2
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Country
Daytime Phone
*
Evening Phone
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Please add me to your mailing list
*
Yes
No
Skills & Interests
Current Occupation:
Education Background:
Hobbies, Skills & Interests:
Previous Volunteer Experience:
How did you hear about volunteering at Mary Ryder Home?
Have you ever volunteered at Mary Ryder Home?
Yes
No
Preferences In Volunteering
Is there a department or area of Mary Ryder Home with which you are particularly interested in working?
Availability
Which days and times are you typically available to volunteer at Mary Ryder Home?
Monday A.M.
Monday P.M.
Tuesday A.M.
Tuesday P.M.
Wednesday A.M.
Wednesday P.M.
Thursday A.M.
Thursday P.M.
Friday A.M.
Friday P.M.
Saturday A.M.
Saturday P.M.
Sunday A.M.
Sunday P.M.
References
Please list three adults, not relatives, who have known at least one year.
Reference #1
Please include name, phone number (both day and evening) and address
Reference #2
Please include name, phone number (both day and evening) and address
Reference #3
Please include name, phone number (both day and evening) and address
Have you ever been convicted of a felony within the past five years?
Yes
No
If yes, please explain:
Agreement
I hereby affirm that my answers to the foregoing questions are true and correct to the best of my knowledge and I understand that false statements on this application shall be considered sufficient cause for termination from the volunteer program. I hereby give my consent for reference checks, a criminal records check and a child abuse hotline check with the applicable governmental agencies.
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