CONTACT INFORMATION First and Last Name
Preferred Pronouns
Date of Birth
Email
Phone Number
Street Address
Apt/Unit
City
State
Zip
INTERESTS AND BACKGROUND If you selected "Other," please explain:
If you selected "Other" above, please explain:
If you selected "Other," please explain:
Have you ever applied to be a volunteer with The Home for Little Wanderers or any child welfare agency? If so, please explain.
Why do you want to volunteer at The Home for Little Wanderers?
Please describe the position or activities you would like to do in your volunteer work.
Please share any relevant experience you have working with youth or young adults (volunteer or paid).
What do you hope to gain from your volunteer experience?
Please list any hobbies, activities or special skills that you could share with our youth in your preferred volunteer role.
How often do you see yourself volunteering? For example: monthly, weekly? How many hours?
EDUCATION Name of High School
Address
Years attended
Name of College
Address
Years attended
Name of Graduate School
Address
Years attended
Please share any degrees you have here:
Please share any professional licenses or certifications that you currently hold here (License title, license number and expiration date):
EMPLOYMENT HISTORY Please share details of your current employment, if applicable. Company
Job Title
Responsibilities
Phone
Address
Supervisor
Please list any additional skills, training, volunteer work or other experiences you feel may be relevant.
I hereby apply for a volunteer position at The Home for Little Wanderers. I understand The Home for Little Wanderers will interview me about my background, motivation, expectations and other personal qualities that might have bearing on whether I would be an appropriate volunteer. Additionally, I understand that The Home for Little Wanderers will investigate any and all facts concerning qualifications for becoming a volunteer. I certify that all information provided by me in this application is complete, true and accurate. I acknowledge that the intentional omission or falsification of information will be cause for refusal of placement or immediate dismissal at any time during the period of my placement I understand that statements I make to staff of the agency will be held confidential within the agency, unless disclosure is required by law. Specifically, I understand that incidents of child abuse or neglect, past or present, or threat of harm to or by a child are issues that must be reported to proper authorities. I understand that my application will not be considered unless it is complete and signed and until any required supplemental information is submitted and complete. I agree to notify The Home for Little Wanderers immediately of any changes in the information provided in the application process, including, but not limited to, my legal status, driving record, job change, address change, telephone change, name change or marital status. I certify that the information on this application is correct. I give permission to The Home for Little Wanderers to investigate the information provided on this application, I waive the right to make any claims based on defamation in connection with check checks, and hereby agree to indemnify and hold harmless the agency and its directors, employees, and agents with respect to their good faith efforts to administrate, manage and operate the program to which I am applying. The Home for Little Wanderers provides equal opportunity for all, regardless of age, sex, color, race, creed, national origin, ancestry, genetics, religious persuasion, sexual orientation, marital status, political belief, or disability that does not prohibit performance of essential volunteer functions. This application and any additional information will remain the property of The Home for Little Wanderers and will remain confidential.
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