Please complete this application if you are interested in becoming a Holland Home volunteer. Once you complete the application, click the Continue button at the bottom. We appreciate your willingness to serve and look forward to meeting you!
We are actively seeking volunteers for our Breton Woods and Raybrook residential campuses as well as support at our Corporate Office.
Please note which location(s) you are interested in volunteering at:
Please share why you are interested in volunteering at Holland Home and what you are interested in doing?
Have you ever been convicted or plead guilty or no contest to a crime?
Do you have any felony charges pending against you? If yes, please list.
Please enter your full legal name.
An investigation consumer report consisting of a criminal conviction background check will be obtained on all new employees and volunteers of Holland Home. This report will be used for employment and volunteer purposes only. You have the right to make a written request within a reasonable period of time for information concerning the nature and scope of the investigation. In the event you desire this information, please contact the Human Resources Department (employees) or the Volunteer Office (volunteers). This Notice is authorized by the Fair Credit Reporting Act, Section 604(b).
I authorize Holland Home to conduct a criminal background check with the State Police, County Sheriff Departments, and/or a Consumer Reporting Agency for the purpose of determining my suitability for employment/volunteer work with Holland Home. I have listed all crimes for which I have been convicted, including the date of such convictions, as well as any pending felony charges. I acknowledge that any omission or falsification of this form shall be grounds for discharge if I am employed or assigned as a volunteer.