St. Francis House: Survey - Volunteer Application

Volunteer Application

1.

Please enter the following contact information:

*

Name:

First Required	Last Required

*

Email: Required

*

Street 1: Required

*

City/State/ZIP:

City Required	State Required	ZIP Required

*

Phone Number: Required

Yes, I would like to receive e-mail from St. Francis House

Yes, I would like to receive postal mail from St. Francis House

Remember me. What's this?

Emergency Contact Person

2.

Question - Not Required - Name:

3.

Question - Not Required - Relationship:

4.

Question - Not Required - Telephone:

EDUCATION

5.

Question - Not Required - Are you currently a student?

6.

Question - Not Required - High school:

7.

Question - Not Required - Area of study:

8.

Question - Not Required - College:

9.

Question - Not Required - Area of study:

EMPLOYMENT

10.

Question - Not Required - Are you currently employed?

Present employer

11.

Question - Not Required - Name:

12.

Question - Not Required - Address:

13.

Question - Not Required - Telephone:

REFERENCES (Two persons who have knowledge of your work /volunteer experience)

14.

Question - Not Required - Name:

15.

Question - Not Required - Address:

16.

Question - Not Required - Telephone:

17.

Question - Not Required - Name 2:

18.

Question - Not Required - Address 2:

19.

Question - Not Required - Telephone 2:

PERSONAL SKILLS and INTERESTS

20.

Question - Not Required - (Please list)

(Maximum response 255 chars, approx. 5 rows of text)

21.

Question - Not Required - Any skills in computers, word processing, typing? (Please describe)

(Maximum response 255 chars, approx. 5 rows of text)

22.

Question - Not Required - Language abilities

(Maximum response 255 chars, approx. 5 rows of text)

23.

Question - Not Required - Please check the volunteer opportunities that interest you.

	Area of most need
	Kitchen - meal prep & service
	Kitchen - pot/pans & dish machine
	Dining Room service
	Day Center Hospitality
	Housing
	Clothing Operations
	Employment
	Clerical work
	Women's Lounge
	ESL Classroom
	Tutoring/teaching

24.

Question - Not Required - Which volunteer opportunity is your first preference?

HOURS AVAILABLE FOR SERVICE

25.

Question - Not Required - Monday:

26.

Question - Not Required - Tuesday:

27.

Question - Not Required - Wednesday:

28.

Question - Not Required - Thursday:

29.

Question - Not Required - Friday:

30.

Question - Not Required - Saturday:

31.

Question - Not Required - Sunday:

32.

Question - Not Required - Holidays:

33.

Question - Not Required - Date available to start:

34.

Question - Not Required - Why do you want to volunteer at St. Francis House?

(Maximum response 255 chars, approx. 5 rows of text)

35.

Question - Not Required - Is this a required community/school service?

36.

Question - Not Required - Hours required?

37.

Question - Not Required - Contact person for Service Accountability (name & phone):

NOTE: St. Francis House may require a Criminal Record (C.O.R.I.) check for any person who applies to become a regular volunteer.