"Being the Change"

The Community MissionTHE MISSION/FULLER CENTER Volunteer Application 

Applicant Information

Full Name:____________Last  _____________First______-________M.I.____________
Address:  _________________________Phone:________________Email ____________________
Date Available: ____________

Are you a citizen of the United States? __YES  __NO  If no, are you authorized to work in the U.S.?  __YES  __ NO
Have you ever worked for this company?__YES  __NO If yes, when?

Have you ever been convicted of a felony? __YES  __NO

If yes, explain: 

When are you available for volunteer assignments?

  ___ :_____ to ___:_____ Monday     ___ :_____ to ___:_____ Tuesday     ___ :_____ to ___:_____ Wednesday      ___ :_____ to ___:_____ Thursday   ___ :_____ to ___:_____ Friday___ :_____ to ___:_____ Sunday_________ On Call for Food Delivery/Unloading/Pick Up  


___ AIDS/ HIV   ___ Homelessness/Hunger/Food Pantry    ___ Environment/Clean Up Projects   ___ Children and Youth   ___ Volunteer Leadership ___Driver/Delivery  ___ Health/ Wellness   ___ Disaster Assistance   ___ Building/ Repair   ___ Seniors   ___ Fundraising ____ Inventory/Retail Management____ Board Service  _____ Professional Services(Attorney, Architect, Clinician etc.)                    ___ Disability Services    ___ Youth Volunteering  

Special Skills or Qualifications 

 Skills and qualifications can be acquired through employment, previous volunteer work, or other activities such as hobbies or sports. What skills or qualifications do you have as a volunteer?  

   Previous Volunteer Experience   Have you worked as a volunteer before? If so, what did you do?     

Person to Notify in Case of Emergency _________________ 

 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. Thank you for completing this application form and for your interest in volunteering with us.   

 Agreement and Signature                   
 Signature:_________________________________ Date:_____________