Volunteer Application Form Contact Information
Name
Address
City, State, Zip code
Home Phone
Work Phone
Email Address
Availability
Weekday Mornings
Weekend Mornings
Weekday Afternoons
Weekend Afternoons
Weekday Evenings
Weekend Evenings
Interests
Tell us in which areas you are interested in volunteering. Add to the list if your interest is not listed.
Office Administration (Records, Filing, Phone Reception, greet visitors, information and referral)
Recycling Program and Neighborhood Clean Ups
Community Gardening
Finance and Fundraising
Community Development and Economic Planning Committee
Crime Prevention and Block Club Organizing
Action Committee (Welcome Kits, Crime Prevention, National Night Out, Youth)
Special Services (Legal consultation, organizational development, training)
Events (Planning and organizing special events, meetings and forums)
Field work (Door to door canvassing, community outreach, issue analysis and strategy)
Fundraising (Finance Committee, Grant writing, Prospect Research, Evaluation)
Marketing and Publicity (Media relations, writing articles, web resources, brochures, graphics)
Phone Reception and Outreach
Newsletter production (on-line and print communication to community stakeholders)
Volunteer coordination (Assist staff and Board with leadership recruitment and development)
Translation (Assist staff with both cultural and language translation – verbal, written and culturally specific outreach)
Youth work (Homework assistance, field trip chaperones, assist staff with job and life skills curriculum, provide respectful positive mentoring to young person living in District Five)
Transportation (Obtain defensive driving class and offer occasional transport to community participants)
Special Skills ( Example: Cooking, Mentoring, Construction, Tutoring, Cleaning or Maintenance, Sewing, Gardening, Small Business owner, recreation, providing hospitality, conducting research, etc.. Please list below.)
Other, Please explain
Your Unique Interests, Skills and/or Qualification
Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.
Previous Volunteer Experience
Summarize your previous volunteer experience.
Person to Notify in case of Emergency
Phone
Agreement
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in being dismissed from the program. I agree to abide by all discussed confidentiality, communication and volunteer policies that may affect this position.
Agree
Initials
Policy
It is the policy of District Five Planning Council to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability. This information will be treated with respect and confidentiality.
Thank you for completing this application form and for your interest in volunteering with us.
