Volunteer Application
Thank you for your interest in the Boys & Girls Clubs of the Fox Valley! If you have any questions, please contact:

Madeleine Cohen, Mentoring Coordinator
Email: mcohen@bgclubfoxvalley.org

160 S. Badger Ave. Appleton, WI 54914

Email address *
Have you lived outside Wisconsin in the last 7 years?
Date *
MM
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First and last name *
Your answer
Address (including city/state/zip code) *
Your answer
Home Phone #
Your answer
Cell Phone #
Your answer
Date of birth *
MM
/
DD
/
YYYY
Employer/School *
Your answer
Licensed Driver? *
Required
Insured Driver? *
Required
Emergency Contact Name *
Your answer
Emergency Contact relationship to you *
Your answer
Emergency Contact phone # *
Your answer
Ethnicity (optional)
Where did you learn about our volunteer opportunities? (Please check one) *
Required
If BGC employee/online/other, please include the name or source
Your answer
Reason you want to volunteer at the Boys & Girls Clubs of the Fox Valley (Check all that apply):
If requirement, how many hours do you need?
Your answer
If other reason, what is it?
Your answer
Preferences and specific interests at the club
The next questions will ask what age groups you are looking to work with, along with your interests as they relate to the Club. Check as many or as few as you like!
Members of the Boys & Girls Club are ages 6 to 18. Which age groups would you most enjoy working with? Check as many as you would like!
Serving 6-12 Year Olds:
Other (please specify)
Your answer
Serving "The Club" Teen Center (13-18 Year olds):
Other (please specify)
Your answer
Type of volunteer work that interests you. Check all that apply:
Availability
This section will determine the best days and times for your volunteer activity. Please mark all the days and times you will be available to volunteer.
Mark which day(s) and time(s) you are available
Mornings (8am-11am)
Afternoons (12pm-3pm)
Evenings (3pm-8pm)
Monday
Tuesday
Wednesday
Thursday
Friday
Special Notes Regarding Availability
Your answer
References
Two references will be contacted on your behalf. References should know you well and be able to attest to your character, skills and dependability.
Reference #1: Immediate family member
Full Name
Your answer
Relationship to applicant
Your answer
Reference Contact Phone
Your answer
Reference email address
Your answer
Reference #2: Supervisor, co-worker, friend, pastor, teacher, etc.
Full Name
Your answer
Relationship to applicant
Your answer
Reference Contact Phone
Your answer
Reference email address
Your answer
*All references must fill out a reference form. Please send the link below to your reference(s) for them to complete.
By checking here, you certify that you have selected your references and sent them the link above *
Submit
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