| Name:____________________________________________________________________________ |
| Address:__________________________________________________________________________ |
| City, State,
Zip:_____________________ |
State____________ |
Zip____________ |
| Phone:___________________________________________ |
|
| Emergency
Contact: Name:___________________________ |
Phone:___________________ |
| Email
Address:_____________________________________ |
|
| Student?
Y___ N___ |
| Year_____
Major(s):_______________________________________________________________ |
| Class
Project: Y___ N___ |
| Dept:_________________
Course______________________ Prof:_________________________ |
|
| Profession
/ Work
Experience:_______________________________________________________ |
| ________________________________________________________________________________ |
|
| Previous
Volunteer
Experience:______________________________________________________ |
| ________________________________________________________________________________ |
|
| Why
Do You Want To Volunteer At Martha's House? |
| Personal
Enrichment:___ School Credit:___
Other:____________________________________ |
| ________________________________________________________________________________ |
|
|
___ I am willing to make a six month commitment to my
volunteer program. |
|
| Skills
and interest I would like to develop while
volunteering:_______________________________ |
| ________________________________________________________________________________ |
|
| Days
and Hours of Availability: |
| Sunday |
Monday |
Tuesday |
Wednesday |
Thursday |
Friday |
Saturday |
| |
|
|
|
|
|
|
|
|
| How
did you here about us? Website:___ Friend
/ Volunteer:___ Other:L________________ |
| _______________________________________________________________________________ |
|
| I_____________________________,
Volunteer to participate with Martha's House Inc. |
|
| Volunteer
Printed
Name:___________________________________________________________ |
| Volunteer
Signiture:_______________________________________________________________ |
Volunteer
Application