Volunteer Application

Volunteer Information

First Name

Last Name

Address

City

Zip

Cell Phone

Home Phone

Email Address

Preferred Contact Method

Phone

No Preference

Date of Birth

Would you like to receive the Newsletter and Volunteer Updates?

Yes

How did you hear about Volunteering at MRC? (choose one)

Brochure/Flyer/Website	Community Agency/Non-Profit	Faith Community
Family/Friend	Group Member	Health Provider
Legal/Judicial	Mass Media	Social Media
Social Worker	Other

In case of emergency, notify:

Relationship?

Emergency Contact Phone

Please share your weekly availability by selecting the appropriate days/times

Monday	Tuesday	Wednesday
Thursday	Friday	Saturday
Morning	Afternoon	Evening

Are you willing to be on call for additional shifts?

Yes

Please select your areas of interest/ skills (select all that apply)

Community Café	Culinary Adventures	Events	Family Education
Food Share/ Mobile Food Share	Front desk	Workforce	Clerical work
Computer usage	Customer Service	Driving	Event Planning
Fundraising	Greeter	Landscaping	Manual Labor
Marketing	Stocking	Working with Children

Languages Spoken

English

Spanish

Other

Volunteer and Work History

Employer/Organization 1 Information

Name of Organization/Employer 1

Job Title 1

Time Frame 1

Would you like to enter more history?

YesNo

Employer/Organization 2 Information

Name of Organization/Employer 2

Job Title 2

Time Frame 2

Would you like to enter more history?

YesNo

Employer/Organization 3 Information

Name of Organization/Employer 3

Job Title 3

Time Frame 3

Does your employer participate in workplace giving, donation matching, or offer work services days?

Yes

Please explain your employer options

Have you ever been convicted of a felony?

Yes

What was the charge?

Date and jurisdiction of conviction?

Notification and Agreement

By submitting this application, I confirm that the information I have provided is truthful and complete. I understand that if I am placed as a volunteer at Mountain Resource Center, any false statements, omissions, or other misrepresentations made by me on this application might result in my immediate dismissal.

Electronic Signature

Contact Information