Kroc Center Philadelphia Volunteer Application Form
Thank you for your interest in volunteering for The Salvation Army Kroc Center in Philadelphia! Once you complete the form, click the continue button at the bottom. Please note that an * indicates a required field.
General Information
First name:
*
Last name:
*
Title:
Choose
Dr.
Mr.
Mrs.
Ms.
Street 1:
*
Street 2:
Street 3:
City:
*
State:
Choose
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
*
Zip:
*
Home phone:
OK to call me here
Work phone:
OK to call me here
Cell phone:
OK to call me here
Email address:
*
Demographic Information
Date of birth:
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
*
Emergency Contacts
1
2
First name:
First name:
Last name:
Last name:
Home phone:
OK to call here
Home phone:
OK to call here
Cell phone:
OK to call here
Cell phone:
OK to call here
Relationship:
Choose
Co-worker
Daughter
Father
Friend
Mother
Neighbor
Son
Spouse
Supervisor
Relationship:
Choose
Co-worker
Daughter
Father
Friend
Mother
Neighbor
Son
Spouse
Supervisor
Availability
Please indicate the days and times you are usually available to volunteer.
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Morning:
Afternoon:
Evening:
My availability is:
Choose
Ongoing
Ongoing, except between these dates
Only between these dates
*
From:
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
to:
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
I would like to serve up to:
hours:
Choose
Daily
Monthly
One time
Weekly
Location
*
Location Preference:
The Philadelphia Kroc Center
Background Checks
Your social security number is required for entry into a Salvation Army registry and clearance system. Additional background checks will be required for all volunteers working where children are present.
Social security number:
*
Email Preferences
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.
What kinds of email would you like to receive?
Electronic newsletters
Recruitment appeals
Volunteer Status
Have you volunteered for The Salvation Army in the last 12 months? If yes, where?
References
1
2
First name:
*
First name:
*
Last name:
*
Last name:
*
Preferred Phone phone:
*
OK to call here
Preferred Phone phone:
*
OK to call here
Email address:
Email address:
Relationship:
Choose
Co-worker
Daughter
Father
Friend
Mother
Neighbor
Son
Spouse
Supervisor
*
Relationship:
Choose
Co-worker
Daughter
Father
Friend
Mother
Neighbor
Son
Spouse
Supervisor
*
Agreement
The following are the terms of my volunteer service:
1. I understand that The Salvation Army is a religious and charitable organization that requires the assistance of volunteers in the conduct of its various spiritual and social service programs.
2. I undertake to perform services as a volunteer without compensation and that, in performing services, I acknowledge that I am not acting as an employee of The Salvation Army.
3. I understand that as a volunteer, should any accident occur, I may be covered for limited coverage of medical expenses under The Salvation Army liability insurance.
Statement of Volunteers for work with children:
For purposes of this Statement, the words “child” and “children” mean individuals below the age of 18 years. Your agreement is required regardless of whether you will work with children or not.
As the applicant described above, I do hereby represent to The Salvation Army, with the understanding that The Salvation Army will rely upon the information provided in considering my application for work with children, that the foregoing information and following statements are true:
1. In my prior volunteer work, I have never used a name other than that set forth above.
2. I have never been accused of abuse of a child or of actual or attempted sexual molestation of a child, either in a program for children or otherwise.
3. I have never been arrested as a result of a charge of child abuse or of actual or attempted sexual molestation of a child.
4. I have never been convicted of child abuse or a crime involving actual or attempted sexual molestation of a child.
5. I authorize any of the churches or other organizations and their representatives and my personal references listed above to give to The Salvation Army any information they may have regarding my character and fitness for work with children. I release all such organizations and individuals from any liability that may result from their furnishing such information to The Salvation Army. I wave any right that I may have to inspect any records containing such information.
6. I am aware that The Salvation Army is a branch of the Christian Church and I agree that I will conduct myself in my work with children in a way which is consistent with the religious and charitable policies and principles of The Salvation Army.
7. Having provided the foregoing information and having affirmed the foregoing statements are true, I recognize that any false information or statements are punishable under the laws relating to perjury.
I Agree
Continue