APPLICATION FOR VOLUNTEER SERVICES
Adult (18+) Application
College Student Volunteers - Do Not Use this Application:
Sparrow has a partnership with MSU to coordinate all college student volunteers, regardless of where they attend. College students need to apply through the MSU Service Learning Center in Room 27 of the MSU Student Services Building, Service Learning Center at Michigan State University. You can call their office at 517.353.4400 or visit their web site
www.servicelearning.msu.edu
.
*
: An asterisk indicates a required field.
VOLUNTEER CONTACT INFORMATION:
Today's Date:
Referrer Name: (when applicable)
Volunteer Last Name:
*
First Name:
*
Street Address:
*
Apartment:
City:
*
State:
*
Zip Code:
*
Residence Telephone:
*
Business Telephone:
Facsimile:
Pager:
Email Address:
EMERGENCY INFORMATION:
(Person to be Notified in the Event of an Emergency)
Name:
*
Street Address:
*
City:
*
State:
*
Zip Code:
*
Day Telephone:
*
Evening Telephone:
Pager:
EDUCATIONAL INFORMATION:
(Name and Location of School)
High School:
*
Graduate?
Yes
No
Business College/Vocational Training:
*
Graduate?
Yes
No
College/University:
*
Graduate?
Yes
No
Are you attending classes now?
*
Yes
No
Where:
WORK EXPERIENCE:
(List most recent employer first)
Name of Organization:
Type of Work:
From:
To:
Name of Organization:
Type of Work:
From:
To:
Name of Organization:
Type of Work:
From:
To:
VOLUNTEER EXPERIENCE:
(List most recent experience first)
Name of Organization:
Type of Work:
From:
To:
Name of Organization:
Type of Work:
From:
To:
Name of Organization:
Type of Work:
From:
To:
PERSONAL REFERENCES:
(Not relatives or former employers)
Name:
*
Address:
Telephone:
Relationship:
Telephone:
Relationship:
What/who has motivated you to seek volunteer opportunities at Sparrow?
*
CHOICE OF VOLUNTEER POSITION:
First Choice:
*
Second Choice:
Indicate times you are available to volunteer:
*
Mornings
Afternoons
Evenings
Weekday
Week Ends
How long do you anticipate being available to volunteer?
Years
Months
How many times per month would you be interested in serving?
Times Per Month
What do you want to achieve from your volunteer experience?
*
MISCELLANEOUS:
Have you ever been convicted of a misdemeanor or felony?
*
Yes
No
If yes, please explain:
Are you volunteering to satisfy court required community service?
*
Yes
No
If yes, number of hours required:
*
If yes, please list your probation officer's name and phone number:
*
Date of last TB skin test:
SIGNATURE:
Applicant Signature:
* : An asterisk indicates a required field.
Last modified on: 12/28/2007 4:44:43 PM