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Volunteer Application

First Name:


Last Name:


Email:
All information submitted to Haven House will be held in full confidentiality.

Date (mm/dd/yy):
 
Address:
 
City:
 
Zip:
 
Phone:
 
Occupation:
 
Are you 18 or older?:
 Yes
No
How did you hear about Haven House?:
 
What type of volunteer work are you most interested in?:
  Select all that apply
 Children's Program
Director's Board
Fundraising
Maintenance
Office Aide
Food Bank
Meal Preparation
Managing donations
Other
Do you have any previous volunteer or employment experience in the field of family services? If yes, please describe.:
 
Have you ever had personal or professional experience in dealing with problems of low-income families? Briefly describe.:
 
Please share with us some of your strengths, special qualifications, or personal experiences that would be an asset to you as a volunteer for this program.:
 
Are you a student? If yes, what is your area of study?:
 
Are you volunteering to complete a course requirement? If yes, what is your area of study?:
 
If volunteering is to satisfy a course requirement, when do the hours need to be complete and how many hours do you need?:
 
Do you speak a language other than English? Which language?:
 
Have you ever been arrested or convicted of a crime? YES or NO. If YES, please describe.:
 
Will you be able to donate at least 4 hours per week, for at least 6 months?:
 Yes
No
Are you available at the following time? (Generally morning is 8-1, afternoon is 1-5 and evening is 5-10. There is some flexibility possible in the schedule.):
  Select all that apply
 Monday morning
Monday afternoon
Monday evening
Tuesday morning
Tuesday afternoon
Tuesday evening
Wednesday morning
Wednesday afternoon
Wednesday evening
Thursday morning
Thursday afternoon
Thursday evening
Friday morning
Friday afternoon
Friday evening
Please list the Name, phone number and relationship for three references below.

Reference 1.:
 
Reference 2.:
 
Reference 3.:
 
:
 
Please stop at Haven House and sign a release so we can perform a criminal background check. We cannot process your application any further until we receive that. Thank you for your interest in Haven House.


Security Code:
 
 (Please enter the letters you see in the image above)