Harbor House Volunteer Application

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Thank you for your interest in volunteering with Harbor House. Please fill out this application so we can get to know you better. We will be in touch soon with any opportunities that match your interests.

First Name *

Last Name *

Preferred Name

Mailing Address (street) *

Mailing Address (city) *

Mailing Address (state) *

Mailing Address (zipcode) *

Home Phone Number

Mobile Phone Number *

Email Address *

Gender *

Female

Male

Prefer not to say

Other:

Date of Birth (mm/dd/yyyy) *

YYYY

Ethnicity *

African American

Asian

Caucasian

Hispanic/Latino

Middle Eastern

Native American

Pacific Islander/Native Hawaiian

Other:

Primary Language *

English

Spanish

Mandarin

Cantonese

Vietnamese

Arabic

Other:

Other Languages You Speak

Spanish

Mandarin

Cantonese

Vietnamese

Arabic

Other:

Clear selection

Church Affiliation (if any)

Volunteer Group Affiliation (if any)

How did you hear about Harbor House? *

Why do you want to volunteer at Harbor House? Please describe any relevant volunteer or work experience and what you hope to learn from your volunteer experience. *

Employment or Education Status *

Employed

Unemployed

Retired

Student

Required

School or Employer

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Phone 1 *

Emergency Contact Phone 2

Reference 1 Name - Please list a reference who can verify your work and/or volunteer experience (supervisor, teacher, pastor, etc) *

Reference 1 Relationship *

Reference 1 Phone *

Reference 1 Email Address *

Reference 2 Name - Please list a second reference who can verify your work and/or volunteer experience (supervisor, teacher, pastor, etc) *

Reference 2 Relationship *

Reference 2 Phone *

Reference 2 Email *

Availability for Volunteering - Days *

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Required

Availability for Volunteering - Times *

Morning

Afternoon

Evening

Required

Availability for Volunteering - Frequency *

Weekly

Monthly

Quarterly

Annually

Which program area(s) you are interested in volunteering for? *

Education - Elementary and Middle School Students (Tutoring, After-school Program on-site at HH))

Education - Tutor the Tigers (Reading program for students off-site at Franklin Elementary)

Leadership Development -Teens (Youth Leadership Program)

Spiritual Formation (Soul Care Groups)

Food Access (Food Distribution)

Administration/Office Support

Facility Maintenance

Gardening

Fund Raising

Field Trip Driver

Enrichment Club Leader

Other:

Required

Have you at any time ever been convicted of, or pleaded guilty or no contest to any crime? *

Yes

Have you at any time ever participated in, or been accused, convicted, or pleaded guilty or no contest to abuse or any sexual misconduct? *

Yes

Are you aware of any traits or tendencies within yourself that could pose any threat to children, youth, or adults? *

Yes

If you are applying to work with children, you will be asked to be fingerprinted through the Department of Justice as part of a background check. Are you willing to be fingerprinted? *

Yes

Are you in a program that requires you to complete community service hours? *

Yes

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