PRISM by pengxuebo

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									OFFICE USE    Today’s Date:
              Initial Placement:
              Start Date:
              End Date:


Required Information                                                                                                  VOLUNTEER
Name (last, first, MI):                                                                                              APPLICATION
Address:
City:                                            State: MN               Zip:                    Date of Birth:
Home phone: (           )                        Work: (             )                              Cell: (            )
e-mail address:
Emergency Contact Name:                                                                                Relation to you:
Home phone:                                                     Work phone:

Optional Information
How did you hear about PRISM?
Do you belong to one of our member churches?                     Y / N          If so, which?:

Employer or Former Employer:
Does your employer/corporation match funds for charitable organizations?:                                  Yes              No

References (please list two persons not related to you who would have knowledge of your qualifications)

             Name                                                                           Phone #:

             Relationship:                                                                # Years Known:

             Name                                                                           Phone #:

             Relationship:                                                                # Years Known:


For the safety of our clients, volunteers and staff, PRISM requires everyone who works with us to disclose any misdemeanor or felony
convictions they have had. PRISM will run a criminal background check on applicants who wish to work directly with our clients.
Misdemeanor or felony convictions?                    No        Yes (year, charges)

Release to use photos/videos for promotional purposes :
I understand that PRISM may take photos/videos which may include me while I am participating in PRISM activities. I hereby agree to
allow PRISM to use my image for promotional purposes (including, but not limited to newsletters, brochures, display boards or other
materials to share PRISM’s mission and vision).

Signature:                                                                               Date:


Statement of Understanding & Authorization:
I verify that all of the information on this application is true, complete and correct, and I understand that any false statements will result
in disqualification from working as a PRISM volunteer. I understand that I am applying for a volunteer position and that this is not an
application for, nor a contract of, employment. I further agree that as a PRISM volunteer, I will not accept any payment for my services
and that I will incur the cost of my own transportation. I will also participate in any required training applicable to my volunteer work at
PRISM. I authorize the references listed on this application to give PRISM any pertinent information they may have regarding my
qualification to volunteer with PRISM. I authorize investigation of all statements contained on this application, verification of applicable
licensure as it applies to my volunteer position and, if necessary for the volunteer position I am seeking, I authorize PRISM to run a
criminal background check and/or driving record check.

Applicant’s Signature:                                                                Date:
What can we do for EACH OTHER?
PRISM wants your volunteer experience with us to be mutually rewarding. In an effort to make the best use of what you want to offer, the
following is a list of things you can do here at PRISM. Whatever you’d like to help with, you’ll be given training and staff support so you can be
confident your contribution of time and energy is making a real difference in the work PRISM does and the lives PRISM touches.

PRISM Programs                                                              Event Planning
Food Shelf                                                                  Help    Chair
                                                                            plan    event
       Assisting clients with shopping
                                                                                            PRISM Summer Scramble Golf Outing (Sep)
       Sorting & organizing food
                                                                                            Fall Luncheon & Silent Auction (Oct)
       Ordering & maintaining stock
                                                                                            Sleep-Out for Homelessness Awareness (Nov)
                                                                                      N/A   Agency Tours
Clothing and Household                                                                N/A   Agency Fund-Raising Breakfasts/Events
       Assisting clients in Clothes Closet, Birthday Shop and School                        Donor Management (work with corporate sponsors,
       Supply Shop                                                                          event-specific donors, auction items, etc)
       Sorting & organizing clothing, household items, toys, etc.                           Publicity & PR
Reception/Office Management
       Reception (answering phones, greeting clients/volunteers)            Other Skills, Interests & Expertise
       Phone calling/reminder calls
       Clerical (Filing, copying, other tasks as needed)                            Audio-Visual Editor (creating videos, PR materials, etc.)
       Data Entry                                                                   Building Care (cleaning & “fix-it” person)
                                                                                    Childcare (during meetings/classes)
Automotive Repair                                                                   Computer Support (hardware, software, programming)
       Mechanic – diagnose and repair vehicles                                      Data Management (entry and/or analysis)
       Runner – move & park cars, pick up parts, assist mechanics                   Entertainer/Musician (event-specific)
       Scout – visit auto auctions, scout out good vehicles for shop                Fund-raising (letter-writing, phone-calling, personal visits)
                                                                                    Historian/Archivist (sorting/scrap-booking photos)
                                                                                    Mailings (stuffing, sealing, bringing to Post Office)
                                                                                    Newsletter Team
                                                                                       Ad Sales       Editing         Layout/Design      Writing
                                                                                    Photographer
Leadership                                                                          Pick-up/Delivery (resources to/from PRISM)
                                                                                    Pick-up/Delivery (furniture from donors to clients)
                                                                                    Speaker/Presenter (speaking publicly about PRISM)
Leading & Promoting the PRISM organization
                                                                                    Other
      Executive Board (governance & policy making)
      Church Partner Board (church liaison for events, drives)
      Friends of PRISM (event planning)                                      Availability     Mon      Tue      Wed     Thurs    Fri     Other
                                                                               8:30-12:30
                                                                                1:00-5:00
                                                                                5:00-8:00

								
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