Volunteer Application

Name and Address

First name:

Last name:

Street 1:

Street 2:

City:

State:

* Zip: *

Primary phone:

Secondary / Other phone:

Email address:

Personal Information

Date of birth:

Gender:

Emergency Contact

First name:

Last name:

Cell phone:

Email address:

Relationship:

Affiliation(s)

With what local church, business, university and/or other organization are you affiliated?

Church Affiliation:

Other Affiliation:

Individual or Group

Please indicate whether you are applying as an individual or group.

Kind:

Individual Group

Group name:

Members:

Motivation to Volunteer

Why do you want to volunteer at the Milwaukee Rescue Mission?

Volunteer Opportunities

Which volunteer opportunities interest you? Select all that apply.

Availability

Please indicate the days and times that work best for you to volunteer.

Community Service

Are you volunteering to fulfill a class requirement or court-ordered community service?

Class requirement:

Court-ordered community service:

If you checked either box, how many hours of volunteer service do you need to complete?

Special Accommodations

Please share any special accommodations you would like us to know. (e.g. allergies, physical limitations, etc.)

Background History

Do any of the following apply to you? Please answer "yes" or "no" to each.

Pending criminal charges:

Convicted of a crime:

Accused of child neglect/abuse:

Questionable history around youth:

Use of illegal drugs:

If you answered "yes" to any of these questions, please explain:

Legal

I have read, understand and will adhere to the Volunteer Guidelines for the Milwaukee Rescue Mission. I understand that completing this application indicates my interest in volunteering at the Milwaukee Rescue Mission and that additional steps are required before I can be accepted as a volunteer, including a criminal background check. I give permission to the Milwaukee Rescue Mission to conduct a background check, and I certify that all the information that I have included in this application is correct.

I Agree