Volunteer Application

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Volunteer Classification
- Resident Volunteer
- Community Volunteer
- Junior Volunteer
- Staff Volunteer
- Occasional/Seasonal Volunteer
Name
FirstLast
Are you 18 years or older?
- Yes
- No
Gender
- Male
- Female
Address
Street AddressCityStateZip Code
Phone
Email Address
Have you ever been convicted of any misdemeanor or felony (this includes without limitation, pleading guilty, pleading no contest, or having a finding of guilty)? (Conviction is not an automatic bar to volunteer placement. Each case is reviewed on an individual basis.)
- Yes
- No
If yes, Please list:
Name(s) at the time
Date(s)
Location(s) - city, state
Type of Offense(s)
In case of emergency, notify:
Name
FirstLast
Relationship
Phone
Cell Phone
May we call if necessary?
- Yes
- No
Emergency Contact Employment Information
Retirement Status
- Retired
- Employed
Company
Position
Address
Street AddressCityStateZip Code
Phone
Approximate number of hours per month you will volunteer?
Days Available
- Sunday
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Saturday
Times Available
How were you referred?
Volunteer Work Objective
- Good Use of Free Time
- Do Something for Others
- Develop New Skills
- Explore Careers
- Work with People
- Fun and Relaxation
- Share Skills
- Other
Other, please specify
Do you belong or serve on any clubs, organizations or committes? Please specify.
Do you speak any foreign languages? If yes, Please specify
Special interests/hobbies
Past volunteer experience
Special Skills: Please Check
- Administration
- Marketing
- Planning
- Teaching
- Business
- Advertising
- Research
- Volunteer Recruitment
- Budget/Finance
- Volunteer Mgt.
- Writing/Editing
- Nursing
- Public Relations
- Website/Internet
- Graphic Arts
- Spiritual Care
- Legal
- Fund Raising
- Database Mgt.
- Music
- Other
Other, please specify
*
- I Agree
When you Submit this completed form on-line you authorize St. Leonard to process the information contained within and submission constitutes your signature.

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