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Volunteer Application

Please complete the application below if you would like to volunteer for Gift of Life Family House.

* Required Fields
First Name*
Last Name*
Address*
City*
State*
Zip Code*
Home Phone*
Work Phone
Cell Phone*
Email Address*
Retype Email Address*
Employment Information. I am: (*must be 18 years of age or older to volunteer, teens 15-17 must be accompanied by an adult)*
EmployedRetired
StudentOther
Employer or School Name
Occupation or Major
Street Address
City
State
Zip Code
What volunteer areas interest you?*
Guest Services (greet guests, check-in/out, prepare guest room, answer phones, etc.)Prepare Guest Chef Meal(s) for Families
Prepare Baked Goods for FamiliesHost a Fundraiser
Join a Speakers BureauHost a Wish List Drive
Host Arts & Crafts/Games/ Family ActivitiesOther
How did you learn about the Family House?*
NewspaperChurch/Synagogue
Family House WebsiteGift of Life Donor Program Website
SchoolOther
Referred by?
Why would you like to volunteer at Family House?*
When are you available to volunteer?*
Weekday morningsWeekday afternoons
Weekday eveningsWeekend mornings
Weekend afternoonsWeekend evenings
Summarize any special skills and qualifications based on your work experience or volunteer experience.*

Words left: 300

Describe other volunteer experiences you've had (Organization, when, type of work)*

Words left: 300

Are you fluent in any languages? Please describe.*

Words left: 300

Have you ever been convicted of, or plead guilty to, a felony or misdemeanor other than traffic violation? *
YesNo
If yes, please describe.

Words left: 300

Are you physically able to perform the essential requirements of a volunteer?*
YesNo
List two references*

Agreement and Signature *

By submitting this application, I affirm that the facts set forth in it are true and complete, and have been given voluntarily. I have answered all of the questions to the best of my ability and I have not and will not withhold any information that would unfavorably affect my application to be a volunteer. I will update Gift of Life Family House if any information on this application changes or of other information that might affect my qualifications as a volunteer. I understand any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate rejection as an applicant to be a volunteer or my termination as a volunteer.

I voluntarily give Gift of Life Family House the right to make an inquiry of my past experience and I agree to cooperate in such inquiries and release from all liability or responsibility all persons, companies, and corporations supplying such information.

In addition, I agree that I will keep confidential all materials that I may read or learn about during my volunteer experience. I will only discuss this information with appropriate staff and never off Gift of Life Family House grounds. If I ever use any part of my experience in writing, I agree that a member of the staff must review it first in order to protect the confidentiality and legal rights of Gift of Life and the families it serves.

Signature (type your full name in the box below)*
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