The Landerholmstead Volunteer Application (Individuals)
Thank you for your interest in a a volunteer position with The Landerholmstead!

Please fill out as much of the information below as possible. By providing your contact information you give The Landerholmstead permission to contact you via these mediums.

The Landerholmstead will not practice or permit discrimination on the basis of sex, gender, sexual orientation, age, race, color, national residence, religion, physical handicap or disability, or any other basis prohibited by law. Additionally, the Landerholmstead will not practice or permit any discrimination based on citizenship/residency status, socioeconomic status, criminal record, personal history, or other identifiers. We strongly believe that every individual can play a vital role.
Email address *
Full Name *
Age *
Legal Name (if different)
Phone Number *
What is your preferred contact method? *
Street Address *
Supplemental Address
City/Town *
State *
Zip *
Are you willing to travel in and around the Seattle area to volunteer? *
I'm applying with... (list names)
What do you hope to get from the Landerholmstead? Check all that apply. *
Required
Are you looking for these services/products indefinitely? *
(However you self identify) Gender *
(However you self identify) Race *
How did you hear about us? *
Are you disabled mentally or physically in any way? (Note that this will not be used to determine your eligibility, but rather to place you in an appropriate position, if applicable) *
If "Yes", please elaborate on what accommodations you require:
Do you possess a valid driver's license? *
Do you possess any special licenses or certifications? *
If "Yes", please elaborate.
What cultural, religious, or other holidays do you celebrate? *
Are there specific days/times that you are available for work or volunteering? *
If "Yes", please elaborate.
What volunteer opportunities are you interested in? (Check all that apply) *
For more information on these, please visit: https://landerholmstead.wordpress.com/volunteer
Required
Emergency Contact #1 (Name, Relationship, and Phone #) *
Emergency Contact #2 (Name, Relationship, and Phone #) *
Is there anything else you'd like to share with us?
I hereby certify that the above information is true and correct to the best of my knowledge. If, at any time, my information or circumstances change, I am aware that I can revise this application by requesting to do so.
Printed Whole Name (as Signature) *
Thank you for applying!
You will be contacted via email regarding your application. If you would like to send us any supplementary information, please email it to landerholmstead@gmail.com.
A copy of your responses will be emailed to the address you provided.
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