ROCHESTER AREA NEIGHBORHOOD HOUSE

Volunteer Application

______________________________________________________________________

Section I – Personal Information:

Please Print

Name: __________________________________________________________________

First         Middle           Last

Address:

________________________________________________________________________

Number Street Apt/Suite #

________________________________________________________________________

City State Zip Code

Home Phone :_______________ Work Phone :______________ Email: __________________________

May we call you at work: ___ Yes ___ No

Volunteer Status: Adult_______ Teen*_________ Group**____________

Name of Organization___________________

*Note: Volunteers must be 18 years of age to work with client related programs

**Note: Groups of children or teens should be accompanied by chaperones

Volunteer Opportunities:

.

Office Volunteer: Assist with staff with administering programs and providing assistance to clients. Assist by answering phones, greeting clients ,filing, copying, completing mailings, and other miscellaneous tasks as needed.

Clothes Closet Volunteer: Assist in maintaining clothes closet inventory and services to clients. Assist by greeting clients, sorting clothing donations and recording client clothing selections.

_____________________________________________________________________________________________

Availability for Volunteer Service:

Days:       Time(s):*     Area of Interest

__Monday   ____________________

__Tuesday    ____________________     Office Assistance ______

__Wednesday    ____________________     Clothes Closet   ______

__Thursday    ____________________   Special Events ______     

__Friday   ____________________ (as needed)

__Saturday    ____________________     Other _____________________

Groups: Please state the type of group and volunteer opportunity you are looking for__________________________

_____________________________________________________________________________________________

Hobbies: ___________________________________________________________________

Skills : _____________________________________ Do you have computer experience: __ yes __ no

How were you referred to us: ___________________________________________________________

Section II – Background Information:

A background check will be performed upon acceptance into this volunteer program.

Employment History: (past three years):

Employer Address       Job Title     Telephone   Dates of Employment

1.___________________________________________________________________________

2.___________________________________________________________________________

3.___________________________________________________________________________

Education:

High School: ______________________________________________________

College:__________________________________________________________

Volunteer Experience: (e.g.: community organizations, church, scouts, schools, etc…)

Organization Address Assignments Dates

1.___________________________________________________________________________

2.___________________________________________________________________________

References:

Name     Address       Relationship        Phone

1.___________________________________________________________________________

2.___________________________________________________________________________

Have you ever been convicted of a felony? ______Yes ______No

Permission to Verify Content:

I ____________________________________ (applicant) hereby authorize verification of all statements herein and release Rochester Area Neighborhood House and all others from liability in connection with same.

____________________________________________________ _______________

Applicant's Signature               Date

Please return to :

Rochester Area Neighborhood House     Tel: (248) 651-5836

Attn: Volunteer Coordinator       www.ranh.org

1234 Inglewood   

Rochester , MI 48308

Volunteer Application.doc      Received __________ Orientation _________ Entered into Database ________

11/07