Volunteer - Adams Place

Name *

First

Last *

Last

Birth Date *

Home Phone *

Work Phone

Email *

Address *

Address

City

State/Province

Zip/Postal

Availability *

Special Skills or Qualifications *

Summarize special skills and qualifications you have acquired from employment, previous volunteer work, education, or through other activities, including hobbies and sports.

Previous Volunteer Experience *

Summarize your previous volunteer experience.

Emergency Contact Name *

First and Last Name of Person to Notify in Case of Emergency

Emergency Contact Phone *

Phone number of Person to Notify in Case of Emergency

Volunteer Application Type *

Group Facilitator

Special Projects

Event Volunteer

Thank you for your interest in volunteering as a Group Facilitator with Adam's Place. A tax deductible $50.00 fee is required to cover the cost of a background check and facilitator. Once your application and fee is received you will be notified by email to schedule your training.

$50.00 will be charged to your credit card.

This application is for high school or employer/employee groups that want to volunteer for special events. Volunteers will only be contacted as needed for special projects/events. We appreciate your interest - thank you for your application.

Credit Card

Exp month

Agreement & Signature *

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. Our Policy – It is the policy of Adam’s Place to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability. Thank you for completing this application and for your interest in volunteering with us.

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Volunteer Form

$50.00 will be charged to your credit card.