The COMMUNITY MISSION

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

INTERESTS

___ 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:_____________