Volunteer Application Form

Thank you for your interest in volunteering with Boston Health Care for the Homeless Program! Our volunteer opportunities are customized based on the applicant’s interests, BHCHP’s needs, and open positions. We will do our best to create an experience that is varied and meets your needs, but cannot guarantee a position.

Contact Information

First name:

Last name:

Title:

Street 1:

Street 2:

Street 3:

City:

State:

* Zip: *

Home phone:

* OK to call me here

Cell phone:

* OK to call me here

Demographics

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.

Date of birth:

Age:

Gender Identity:

Race:

Ethnicity:

What languages do you speak?:

Is there anything else you'd like to tell us about yourself?

Availability

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

Education

Please list your current or most recent degree, if applicable.

Major degree:

Institution:

Degree date:

What are your career objectives?

Employment

Please list your current or most recent employer, if applicable.

Employer name:

First name:

Last name:

Title:

Street 1:

Street 2:

Street 3:

City:

State:

Zip:

Home phone:

Work phone:

Skills & Experience

You may optionally provide the following information. It is used only to help us get a better idea of potential volunteer placements for you.

List any work experience, service, or training you think is relevant to BHCHP:

Motivation for Applying

You may optionally provide the following information. It is used only to help us get a better idea how to support you in your service and professional goals.

Why have you applied to volunteer with BHCHP? What experience do you hope to gain?

References

Because the well-being of our patients is of greatest importance to us, we are careful about making sure the volunteers we recruit and place have a sense of responsibility and compassionate maturity. For this reason, we require two references so we're able to get to know you better.

1

2

First name:

Last name:

Title:

Street 1:

Street 2:

Street 3:

City:

State:

Zip:

Work phone:

OK to call here

Work phone:

OK to call here

Cell phone:

OK to call here

Cell phone:

OK to call here

Email address:

Relationship:

Emergency Contact

In the event of an emergency whom should we notify?

First name:

Last name:

Title:

Street 1:

Street 2:

Street 3:

City:

State:

Zip:

Home phone:

* OK to call here

Cell phone:

* OK to call here

Relationship:

Email

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.

Email address:

What kinds of email would you like to receive?

Electronic newsletters

Recruitment appeals

Training announcements

Fundraising appeals

Preferred Role

We have a wide range of roles and shifts available, which you can review at https://www.bhchp.org/individuals. Please list your top 3 or so roles and shift preference, keeping in mind availability can change rapidly. If the roles listed don't quite meet what you're looking for, please use this space to describe how you see volunteering with us.

I Agree

I understand and agree that submitting this application form does not automatically register me as a Boston Health Care for the Homeless Program volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering.

By submitting this form, I attest that the information I have provided on the form is true and accurate.

I Agree