Volunteer Application

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Date *

Name *

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Last

Address

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Zip Code

Daytime Phone *

Evening Phone

Best time to call

Email *

Emergency contact name and phone number

Current Employer

Address

Position

How many hours per week/month can you volunteer?

What are the most convenient days/hours

Anticipated length of commitment you feel you can make?

Please list any current or previous volunteer experience:

What experience have you had with the elderly?

Please tell us briefly why you would like to volunteer with the elderly at this time?

What have you most enjoyed about your previous volunteer and employment experience?

Is there anything you have not enjoyed about your previous work and employment?

What are some of your special interests, skills, and languages spoken?

Do you have any physical or emotional conditions that you would like us to be aware of or that might effect your volunteering?

Please list two people we can contact for references. Please include one Professional relationship such as a supervisor, teacher, minister, Rabbi, etc

Name *

First

Last

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Relationship to you

Length of time known

Name *

First

Last

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Relationship to you

Length of time known

Thank you for your interest in volunteering with Hale-Barnard Services for Older people.

Catherine Logan / Director of Activities (617) 536-3726 x122

Website

Volunteer Application

Please list two people we can contact for references. Please include one Professional relationship such as a supervisor, teacher, minister, Rabbi, etc

Thank you for your interest in volunteering with Hale-Barnard Services for Older people.

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