La Casa de Esperanza
Volunteer Application
* Required
First Name
*
Your answer
Last Name
*
Your answer
Current Address
*
Your answer
City
*
Your answer
Zip Code
*
Your answer
Phone Number
*
Your answer
Email
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Bilingual/Multilingual?
*
Yes
No
Required
If yes, what languages do you speak fluently?
Your answer
Emergency Contact Person
*
Your answer
Emergency Contact Phone Number
*
Your answer
Relationship to the emergency contact person?
*
Your answer
Do you have any medical conditions or a disability you would like La Casa to be aware of?
*
Your answer
Do you have certifications?
Your answer
Who is your current employer?
Your answer
Are you volunteering for credits or service hours with an institution?
*
Yes
No
Required
Do you authroize La Casa to run a background check?
*
Choose
Yes
No
What is your social security number?
(i.e. 555-12-3456)
Your answer
What day(s) are you available to volunteer?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday (maintenance projects)
Required
What time(s) are you available to volunteer?
*
9 am
10 am
11 am
12 pm
1 pm
2 pm
3 pm
4 pm
Other:
Required
How many hours per week would you like to volunteer?
*
Choose
1-3 hours
3-6 hours
6-9 hours
9+ hours
Volunteer Interest?
*
Administrative work: data entry, clerical, etc.
Café Esperanza (Restaurant work)
Childcare
Computer Instructor
Crossing Guard for Children: 8:30 am, 11:30 am and 3:30 pm
Facilities Maintenance: organization and clean-up
Inventory Checklist & Organization
Lunch aide/assistance
Senior Citizen Activities Assistance
Special Events
Tax Preparer
Tutoring
Workforce Training (resume writing, etc.)
Other:
Required
How did you hear about La Casa de Esperanza?
*
Your answer
Please type your name authorizing all the information on this application is true and accurate.
*
Your answer
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