We appreciate your interest in our organization and are sincerely interested in your background and qualifications. Please answer all questions as thoroughly as possible so we may review this information in consideration of volunteer services with our organization. We are an Equal Opportunity agency and will accept volunteers in designated positions without regard to race, color, religion, sex, national origin, age, disability, veteran status, military status, sexual orientation, genetic information nondiscrimination act or any other locally mandated classifications.

Name and address

First name:

Last name:

Middle 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:

Why would you like to be a RM Volunteer?

Please let us know what made you choose to volunteer with the Rescue Mission.

Skills/Interests

Please list or explain any skills or interests you would like to use/expand at the Rescue Mission.

Criminal History

Have you ever been convicted of a felony or misdemeanor?

Felony or Misdemeanor:

Please list any felony or misdemeanor convictions

Returning Volunteer

Have you volunteered with the Rescue Mission in the past?

Yes or No:

If yes please list all areas you have volunteered

Rescue Mission Services

Please indicate if you have received any of the following services from the Rescue Mission; housing, shelter, meals, and/or outreach services.

Have you used Rescue Mission services?:

If yes please list services utilized

Availability

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

Employment Information

Many companies have charitable foundations that encourage or require employee support. Your employment information can help the Rescue Mission receive grants for our programs!

Employer Information

Employer name:

Street 1:

City:

State:

Zip:

Work phone:

Emergency Contact

In case of an emergency you are giving the Rescue Mission permission to contact this individual.

First name:

Last name:

Street 1:

City:

State:

Zip:

Home phone:

Relationship:

Comments/Questions

Volunteer Conditions

I certify that the statements and representations made in this volunteer application are true and correct and have been given voluntarily. I understand this information may be disclosed to any party with legal and proper interest, and I release this agency from any liability whatsoever for supplying such information. I understand that I will not be paid for my services as a volunteer. I agree to abide by the policies and proceedures of the Rescue Mission. I understand that the Rescue Mission will not reimburse me for mileage. As a nonpaid volunteer, I understand that I am not covered by the Rescue Mission's medical insurance. If I am injured while donating services to the Rescue Mission, the Rescue Mission is not responsible for any medical fees. I hereby release the Rescue Mission and its representatives from liability and all other persons, corporations or organizations for furnishing such information. As a Rescue Mission volunteer, I agree not to disclose any written or oral information about clients, employees, donors, volunteers, customers or other confidential information - i.e., organization finances. I understand that the Rescue Mission has a legal and ethical responsibility to maintain client, employee, donor, volunteer and customer privacy. I also agree that no photos or videos may be taken while on Rescue Mission property without prior permission of the Communications Director or the designated employee. I agree that I will obtain and read the Volunteer Handbook and Volunteer Policies. I understand that by submitting this application I will undergo a criminal and background screening process prior to becoming an active volunteer.

I Agree