The Effort -The Family Lifeline Since 1953 : Get Involved! : Volunteer Application

IMPORTANT: Thank you for your interest in becoming a volunteer! Please complete the entire application form below. After reviewing your application, an eligibility interview will be conducted with one of our staff.

Name:

Date of Birth:

Address:

City, State, ZIP:

Home Phone:

Work Phone:

Email Address:

Best day(s) and time(s) to contact you:

Emergency Contact Name:

Emergency Contact Phone:

EDUCATION

Highest Grade Level Completed:

	Grammar
	High School
	College

Degree Attained:

Degree Attained From:

Are you presently enrolled as a student:

	Yes
	No

Name of School:

Degree you will receive and date:

EMPLOYMENT HISTORY

Are you presently employed:

	Yes
	No

Are you retired:

	Yes
	No

Current Employer:

Position:

Phone:

Length of Employment:

Past Employer:

Position:

Phone:

Length of Employment:

VOLUNTEER EXPERIENCE AND TRAINING

(If you have volunteered at another organization)

Organization #1:

When:

How Long:

Your Duties:

Organization #2:

When:

How Long:

Your Duties:

Organization #3:

When:

How Long:

Your Duties:

REFERENCES

(Please provide complete addresses for all references listed)

Reference #1 Name:

Phone:

Relationship:

Address:

City, State, ZIP:

Reference #2 Name:

Phone:

Relationship:

Address:

City, State, ZIP:

References #3 Name:

Phone:

Relationship:

Address:

City, State, ZIP:

BACKGROUND INFORMATION

(Please answer the questions below as completely as possible.)

Do you have any physcial disabilities that may affect or limit your work:

	Yes
	No

If yes, please describe:

Are you on any medication(s) and/or under medical supervision:

	Yes
	No

If yes, please describe:

Have you ever been convicted of a felony:

	Yes
	No

If yes, please describe:

GENERAL QUESTIONS

How did you hear about our volunteer program:

What interests you in volunteering with The Effort:

What foreign language do you speak fluently:

Personal reasons for becoming involved in crisis work:

(crisis line only)

VOLUNTEER INTEREST

Please select the volunteer opportunities in which you may be interested:

	Crisis Line Volunteer
	Community Service Volunteer
	Accounting Intern Volunteer
	Compter Intern Volunteer
	Counseling Intern Volunteer
	Clerical Intern Volunteer

CERTIFICATION OF APPLICANT

By submitting this form, you certify that your answers on this application are true and complete to the best of your knowledge. You also grant your permission and consent for The Effort, Inc. to contact the necessary resources and references to verify your responses on this application.