TOUCH A LIFE INC.
Volunteer Application
(Please Print)
Name: ______________________________________________________ Date: ______________________
Address: ________________________________________________________________________________
City: ______________________________________ State: __________ Zip code: _____________________
Email address: _____________________________________________________@____________________
Home phone: (____)_______________ Work phone: (____)______________ Cellular: (____)_____________
Have you been convicted of a felony? ______ Yes ______ No
If yes, please explain: ______________________________________________________________________
________________________________________________________________________________________
Are you a student? ________ Yes __________No
Date of birth: _________________________________
What school do you attend? ________________________________________________________________
What grade or year are you in? _____________________________________________________________
Have you done volunteer work at another nonprofit?
_________ Yes __________ No
If yes, where and what did you do? __________________________________________________________
What type of volunteer work would you like to do here? __________________________________________
List any hobbies or interests: _______________________________________________________________
What skills, training, or knowledge do you wish to utilize here? _____________________________________
_______________________________________________________________________________________
Why do you want to volunteer here? __________________________________________________________
Where did you hear about our organization? ____________________________________________________
When are you available to volunteer and for how long? ____________________________________________
Time of day of week /How often per week/month/For how long? _____________________________________
________________________________________________________________________________________
TAL VOLUNTEER APPLICATION CONTINUED Page 2
If you have a disability, what accommodation would you need to do this volunteer position? _______________
________________________________________________________________________________________
What training, resources or support do you anticipate needing to do this volunteer work? _________________
________________________________________________________________________________________
Please provide 3 personal or professional references:
(Name, phone number personal or professional relationship)
1.
2.
3.
I hereby agree that the above information is true to the best of my knowledge.
_______________________________________________________ _______________________________
Signature
Todays date
A parent signature is needed if volunteer is 17 years old or younger.
_______________________________________________________ _______________________________
Parent Signature
Todays date
In case of emergency, please contact:
Name: __________________________________ Phone (C) (____)____________ (H) (____)____________
Medical information we should be aware of in an emergency (allergies, special medications, &/or conditions):
________________________________________________________________________________________
________________________________________________________________________________________
