Volunteer Application Form

Thank you for your enthusiasm in volunteering at Tri-Valley Haven! Please click on the link below to take you to our application form, please fill-out the form in its entirety as we do need all the information listed as it helps us match you to the right opportunity.

Name and address

Please fill out this section in its entirety so that we have all your contact information.

First name:

Last name:

Title:

Date of Application:

Type:

Kind:

Individual Group

Group/Company name:

Street 1:

Street 2:

Street 3:

City:

State:

* Zip: *

Home phone:

* OK to call me here

Cell phone:

* OK to call me here

Email address:

Demographic Information

Please 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:

Age range:

Gender:

Education:

Are you Vaccinated?

All staff and volunteers are required to be vaccinated. You will be required to provide a proof of vaccination once your application is approved.

* Can you provide proof of vaccination?:

Yes

Availability

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

Area of Interest

Please indicate your area of interest, this will enable us to match you to appropriate opportunities

Skills

Please check any skills that apply

Have you ever received services from TVH?

Due to conflict of interest, our policy states that clients may not volunteer while they are receiving services from Tri-Valley Haven. Any Tri-Valley Haven client must wait two years before volunteering.

* Have you received services from TVH?:

Yes

Why do you want to volunteer at Tri-Valley Haven?

List any additional skills or certifications.

What are your hobbies & interests?

References

Please provide a professional or personal reference

First name:

Last name:

Home phone:

OK to call here

Cell phone:

OK to call here

Relationship:

Emergency Contact

Please provide the name and contact information of the person we can contact in case of an emergency

First name:

Last name:

Street 1:

Street 2:

City:

State:

Zip:

Home phone:

OK to call here

Cell phone:

* OK to call here

Relationship:

Review and Submit

All the information provided is, to my knowledge, accurate and complete.

I Agree