The Helpers Organization, LLC Volunteer Application Contact Information Name Street Address City ST ZIP Code Home Phone Work Phone E-Mail Address Availability During which hours are you available for volunteer assignments? ___ Weekday mornings ___ Weekend mornings ___ Weekday afternoons ___ Weekend afternoons ___ Weekday evenings ___ Weekend evenings Interests Tell us in which areas you are interested in volunteering ___ Administration ___ Events ___ Field work ___ Fundraising ___ Deliveries ___ Phone bank ___ Newsletter production ___ Volunteer coordination Special Skills or Qualifications Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports. Previous Volunteer Experience Summarize your previous volunteer experience. Person to Notify in Case of Emergency Name Street Address City ST ZIP Code Home Phone Work Phone E-Mail Address Agreement and Signature By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. Name (printed) Signature Date Our Policy It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability. Any views or opinions presented in this disclaimer are solely those of the client and do not necessarily represent those of the organization. Employees or Volunteers of [THE HELPERS ORGANIZATION] are expressly required not to make defamatory statements and not to infringe or authorize any infringement of copyright or any other legal right by The United States Of America and The Commonwealth State of Virginia. Any such communication is contrary to organization policy and outside the scope of the status of the individual concerned. The organization will not accept any liability in respect of such communication, and the EMPLOYEE or VOLUNTEER responsible will be personally liable for any damages or other liability arising. To return your application you may Fax it to 1-888-485-4557 or E-mail it to firstname.lastname@example.org Note* You will be contacted within 24-48 hours to schedule an Volunteer Orientation *Note Thank you for completing this application form and for your interest in volunteering with us.
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