Volunteer Application Volunteer Application All information is Confidential within the Agency. Personal InformationName* First Last Home PhoneMobile PhoneEmail* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Emergency Contact*Emergency Contact Relationship*Education and EmploymentEducation*Please select the last year completed. High School 9th GradeHigh School 10th GradeHigh School 11th GradeHigh School 12th GradeCollege FreshmanCollege SophomoreCollege JuniorCollege SeniorGraduate SchoolName of School/College*Are You Presently Employed?*YesNoIf you selected Yes for Employment:*Full-TimePart-TimeEmployed With:*Occupation*Special Skills, Training, Interests or Hobbies*Please list any current or previous volunteer, internship or work experience:*Volunteer InfoWhat are your volunteer interests?Check all that apply. *Requires 70 hour Training Course. Hotline Volunteer* Presenting Programs (Public Speaking) and Community Outreach* Fundraising Committees Administrative (Reception, typing, data entry, etc.) Staffing Information Tables (explaining services, handing out brochures, etc.) Helping with Mailings Helping with Special Events Direct Service Intern (Must be a current college student in need of field education hours) Other If you selected Other, please describe:Have you volunteered at WRMC in the past?YesNoIf you selected Yes, when?Do you have a Driver's License?YesNoIf you selected Yes, when?Have you ever used our services?YesNoDo you speak another language?YesNoIf you selected Yes, what languages?How did you hear about Women’s Resources, and what do you know about our programs and services?What qualities will you bring with you to the Agency?Can you commit to the 70-hour training program to become a hotline or outreach volunteer, as well as a one year commitment of two overnight hotline shifts a month? (Hotline training class is free with one year volunteer commitment.)YesNoWhat days are you available?Check all that apply. Sunday Monday Tuesday Wednesday Thursday Friday Saturday What times are you available?Check all that apply. Monring Afternoon Evening Overnight Are you available regularly each week?YesNoPlease supply at least two references for admission to hotline training class.Prior to the completion of hotline training, a criminal record check will be made in order to obtain a child abuse clearance.NamePhoneEmail NameI certify that the information provided above is true and correct and I give my permission to verify any of the information I have given above. Please type your name here to give us your consent. First Last CommentsThis field is for validation purposes and should be left unchanged.