General Volunteer (Individual) Application

Please complete this application form if you are interested in becoming a Vera House volunteer. Your interest in volunteering with us is appreciated.

Please answer this as completely as possible to help us match you with the best role. Vera House is an Equal Opportunity Employer. Once you complete the form, click the Continue button at the bottom to submit.

Name and address

You must be 18 years or older to volunteer in our work. If you are under 18, please contact the Volunteer Coordinator at 315-425-0818.

First name:

Last name:

Title:

Street 1:

Street 2:

City:

State:

Zip:

Home phone:

* OK to call me here

Work phone:

OK to call me here

Email address:

Date of birth:

* (year optional)

Demographic Information

You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.

Gender:

Education:

Ethnicity:

Marital status:

College:

Criminal History

Have you ever been convicted of a felony or misdemeanor?

If YES, please list any felony or misdemeanor convictions.

Vera House, Inc. services

Please indicate if you have received any of the following services from Vera House: shelter, advocacy, case management, clinical support, legal assistance, education (please specify if Alternatives or STEPS).

Why would you like to be a Vera House Volunteer?

Please let us know what made you choose to volunteer with the Vera House.

Experience and Skills

Please include a reference or current/recent employer.

Please list any motivating factors, strengths, skills, and/or interests that you feel are relevant or beneficial to the position(s) you are interested in.

1

2

Employer name:

Cell phone:

Email address:

First name:

Last name:

Title:

Work phone:

Cell phone:

Relationship:

...

Availability

Please indicate the days and times you are usually available to volunteer.

You are not expected to maintain consistent interest in one particular Assignment Preference, your preference may change as you learn more about the agency.

Application Date:

Sun

Mon

Tue

Wed

Thu

Fri

Sat

From:

To:

My availability is:

From:

to:

Assignment Preference:

Please share details about availability here:

Transportation

Please share your method of transportation and if you have a driver's license (especially if interested in Sexual Assault Advocate role).

Database Access

In order to keep volunteers up to date with needs and available opportunities to volunteer, we use VICnet (Volunteer Information Center) to post about events and connect with those who have signed up for shifts.

Please enter a password that:

Is between 8 and 30 characters long
Contains both letters and numbers.
Contains a combination of both uppercase and lower case letters.

Password:

Confirm password:

Allow other volunteers to see when I am scheduled

Referral

Let us know how you learned about volunteering with Vera House:

Emergency Contacts

Please provide us with at least one person that we may contact in case of an emergency.

1

2

First name:

Last name:

Cell phone:

Relationship:

Comments or Questions

Please Read and check the box.

ALL APPLICATIONS ARE HELD IN STRICT CONFIDENCE

This application is the first step in exploring volunteer opportunities at Vera House. Candidates are also required to participate in an interview as well as participating in the complete training for their area of interest, including an evaluation process. The opportunities offered are not always a good match for every candidate. If it is determined that a volunteer experience would not be mutually beneficial for the applicant and the agency, the applicant will be notified immediately.

At any time during or after completion of training, the volunteer trainee or volunteer coordinator may determine that a volunteer position is not a good match.

Please check the box to indicate that you understand and agree to this statement.

I Agree