Volunteer Application

Colonial Club Senior Activity Center, Sun Prairie, WI

 

First Name:  

Last Name:   

Home Phone:                  Work Phone: 

Address        

City                            State               Zip  

Educational Background:     

Current/Former Occupation: 

Hobbies/Interests/Activities in which you participate: 
                     

Volunteer Experience:
                     

How did you find out about our need for volunteers?:  

Why do you wish to volunteer?:  

What type of commitment are you willing to make?:

Days and hours available to work:

                         

Check any special skills you have, and areas of volunteer work in which you may be interested. Accounting/bookkeeping:    
Adult Day center activities:   
Blood pressure nurse/receptionist:   
Board committees:
Computer knowledge/training:
Craft/hoppy instructor:
Crafts/sewing:
Home repairs/snow shoveling:
Intergenerational programs:
Mailings/newsletter:
Meal host/hostess:
Music (chorus/chimes/instrumentalist):
Nutrition site helper:
One-on-one visiting:
Driver:
Entertainer/speaker/presenter:
Events planning/assisting:
Faith and Friends:
Filing:
Fundraising:
Gardening:
Gift Shop:
Home delivered meals driver:
Photo albums of Colonial Club events:
Receptionist:
Refreshments/baker:
Typing/data entry:
Trips committee:
Videotaper:
Woodworking:
Writing/editing:
 
Please list any other special skill or services you would like to offer:
          
       
Have you ever been arrested or convicted for a crime?  If yes , please explain:
         

Information needed for a background record check:

Gender: 
Social Security Number:
Birth Date:

Volunteer drivers, please answer yes or no:
     Do you have a valid drivers license?: 
     Chauffeur's license?:                         
     Valid car insurance?:                        


References (list two); Indicate if work or personal reference
Reference #1: 
    Name:
    Personal:              Work:              Phone number:
Reference #2
    Name: 
    Personal:                 Work:            Phone number:

Your Email Address:                

Confirm Your Email Address:   

 

The following question is used to prevent automated spam programs from automatically filling in and submitting this form.  Please supply the obvious answer.

If winter is cold, summer is?

 

For more information:  Call Diana Price-Odonnell at (608) 837-4611, ext. 120, or send an email here. Diana  Price-Odonnell

Volunteer Release Form

I understand my services are being offered on a voluntary basis without anticipation of financial remuneration.  I shall indemnify and hold harmless the Colonial Club Senior Activity Center and employees from and against all claims, demands, loss of liability of any kind or nature for any possible injury incurred during volunteer service.

I understand the Colonial Club Senior Activity Center may require a police/background check.  I grant my permission for such a check.

I understand that volunteers are responsible for maintaining the confidentiality of all privileged information to which they may be exposed while serving as a volunteer.  This information may include personal information about staff, participants, and other volunteers or overall agency business.

Signature of the volunteer:             Date:

Signature of Parent/Guardian (if volunteer is under 18): 

 

 

 

This form uses Huggins' Email Form Script

 CC Volunteer form version 0225092143