Please complete this application form if you are interested in becoming a St. Vincent de Paul Tacoma Pierce volunteer. Once you complete the form, click the Continue button at the bottom.

Name and address

First name:

Last name:

Street 1:

Street 2:

Street 3:

City:

State:

Zip:

Home phone:

OK to call me here

Cell phone:

Email address:

Date of birth:

(year optional)

Why are you interested in volunteering?

Do you have a specific number of hours you need?

How many hours do you need to complete?

When do you need to complete your required hours?

If court ordered, what was the offense?

Criminal history

If you have: a) ever been convited of a felony or b) been convicted of a misdemeanor within the last 2 years which resulted in imprisonment or jail please provide dates and details of all of your convictions.

Availability

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

Sun

Mon

Tue

Wed

Thu

Fri

Sat

From:

To:

My availability is:

From:

to:

Which location are you applying for?

We have two locations. They are

4009 S. 56th St. Tacoma, WA 98408

10417 Canyon Rd E, Puyallup, WA 98373

Please indicate which you are looking to volunteer at

Medical information

Do you have any health conditions or limitations we should be aware of?

Emergency Contact name and phone number

Please provide contact information for at least one emergency contact

First name:

Last name:

Home phone:

Cell phone: