HOPE Volunteer Application

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Volunteer Application

Name *

Phone Number

Address Line 1

Address Line 2

City

State

Zip Code

Email Address

The best way to contact me is:

Home Phone

Cell Phone

Other

At least one response please.

The best time to contact me is:

Morning

Afternoon

Evening

At least one response please.

Emergency Contact Name *

Emergency Contact Phone Number *

Are you a HOPE client? *

Yes

Provide a yes or no response.

Employment

Employed

Not Working

Retired

Clear selection

If not working, who was your last employer?

What year?

Church or Group Affiliation?

Hobbies/Interests

Skills

Why do you want to volunteer at HOPE? *

Is there a particular type of volunteer work you are interested in? *

Conducting food drives

Serving as a Client Choice Food Pantry Assistant

Unloading deliveries and stocking

Other:

Required

When are you available to volunteer? *

My schedule is flexible

Mornings

Afternoons

Evenings

At least one response please.

Do you have a valid Louisiana driver's license?

Yes

Clear selection

Have you ever been convicted of a criminal offense? *

Yes

If yes, please give some general information about the offense?

Do you use illegal drugs? *

Yes

Do you have any disability or are under any course of treatment which might limit your ability to perform certain types of work? *

Yes

If yes, please explain.

How did you hear about HOPE Ministries? *

From Client or Agency

Referred by HOPE Staff or Board Member

Website

Other:

Personal Reference Name

Reference Email Address or Phone Number

Please check to acknowledge that you have read and understand the following: *

As part of the volunteer application process, HOPE Ministries requires all applicants to submit to a criminal background check. The background check may be compiled with information from, but not limited to, departments of motor vehicles and any repository of criminal records. This will not include any report on your credit or personal finances.

I do not understand or I do not agree.

Please check to acknowledge that you have read and understand the following: *

I hereby authorize HOPE Ministries to procure a consumer report which I understand may include information with regard to criminal and driving records.

I do not understand or I do not agree.

Please check to acknowledge that you have read and understand the following: *

I understand that I am responsible for maintaining the confidentiality of all proprietary or privileged information to which I am exposed while serving as a volunteer, whether this information involves a single staff, volunteer, client, or other person or involves overall agency business.

I do not understand or I do not agree.

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