VOLUNTEER APPLICATION

Desired position: (Please check all that apply)

*Front office support_________
*Supervise: computer lab__________, clothing closet__________, outings__________
*Assist with facility repair_______
*Transport clients to scheduled appointments__________
(Must have California Drivers License and evidence of current insurance.)
*Client support (mentor)___________
*Fund-raising drives_________
*Community Service Worker_______
Other (specify) _____________________________________________________________

Type or print name in full: _____________________________________________________

Marital status: ____________ (optional) Spouse’s name:____________________________

Home address: ____________________________________________________________
How long at this address: _______________

Telephone: _______________________ Fax: ______________________

Email: _________________________________ Cell: ______________________

Business name: _________________________ Occupation:________________

Address: ______________________________________________________

Phone: _______________ Fax: ___________ email: ___________________________________

Nature of business: ______________________________________________________________

Membership in other non-profit organizations:
Name Address City State Zip
Other Volunteer / Non-Profit Positions held:
Special skills (i.e., fundraising, strategic planning, finance, legal, marketing, public relations, etc.):
References (please attach):
Brief biography (please attach):
Briefly explain why you want to work with A PLACE ALONG THE WAY (please attach):
Signature: ________________________________ Date: ___________________