Volunteer Application Form

           

       

       

           

(mm/dd/yyyy)    

per hour    OR    per year
* indicates a required field

 

 

Recruitment*

How did you hear about The Douglas Center? (Please check one)
   Company Website
   Newspaper or Online Ad:    Source:  
   Employee Referral:    Employee:  
   Other:    Specify:  

Availability*

       

*Please indicate the times available below (i.e. 9am-4pm):
SundayMondayTuesdayWednesdayThursdayFridaySaturday


Interests

Indicate below the area(s) in which you are interested.
VolunteeringInternship Program
Fundraising Counseling/Therapy
Clerical/Administrative duties Intake and Assessment
Sewing Program Case Management
Music/Dance  
Special Events  
Arts and Crafts  
Gardening/Horticulture  
Money Management  
Community Integration  
Thrift Store/Deli/Cooking  

Education (Put N/A if not applicable)

AttendedName/AddressYears
Attended
Diploma/Degree
Received
High School*
College/
University
Other


Previous Volunteer or Work Experience



Personal/Professional References*

Please list 2 references that are familiar with your work and/or volunteer experience. (References should not be relatives):
NameRelationshipPhone Number


Please Read carefully and sign below

I understand that any false, misleading or incomplete statements made as part of this application or omission of information may be considered sufficient reason for immediate dismissal.

I authorize appropriate personnel of the Agency to investigate my references and to make inquiries of courts and law enforcement agencies resulting from such investigations. Information furnished or recovered as a result of any inquiry will not necessarily preclude my acceptance into the program, but will be considered part of an overall evaluation of my qualifications.

I understand that nothing on the application is intended to create or imply a contractual relationship, if accepted. I understand that the volunteer/internship program is at will and can be terminated with or without reason at any time. Only a written agreement signed by the President & Chief Executive Officer can change my status. Upon termination, I authorize the release of reference information on my work and I hold the Agency harmless for the release of the information.

I understand that I will not be compensated for any hours worked for the Volunteer and/or Internship Programs at The Douglas Center.

Applicant Signature (typed):