Volunteer Application

First Name

Last Name

Maiden Name

Birth Date (No dashes) MMDDYYYY

Address number

Address street

City/State

Zipcode

Emergency Contact Information

Name of person to contact in the vent of an emergency

Relationship to you

Their phone number

List any Medical or Health Condtions that could affect your volunteer assignment

Volunteering Preferences

One time Volunteer

Long Term Volunteer

Community Volunteer

Unsure

Prefered Start Date

Location Preference: Battle Creek | Marshall | Albion

Group Affiliation

Other (please Clarify

Volunteering Opportunities that interest you

Construction

Restore

Hospitality (Providing food for volunteers

Woman build

Rock the Block

Committees (family, selection, fund, development etc.

Other

Please list any skills, certifications, licenses or degrees that you have that would give you an advantage in any of the abvoe volunteer tasks

Availability

1 to 5

5 to 10

10 - 15

Other:_______

What Days are you Avaliable?

Monday

Wednesday

Tuesday

Thursday

Friday

If you are community service volunteer (school/court/dental/etc.) please list how many hours are required to complete here:

Because the nature of our work requires us to work with at risk families and youth, Battle Creek Area Habitat for Humanity requires its volunteers and staff to provide authorization and consent to s standard background check process, as a matter of policy.Have you ever been convicted of a felony? Yes/No If indicated yes when:

I, am requesting to volunteer at the Battle Creek Area Habitat for Humanity. I understand that I am to treat this experience like a job and respectful of other volunteering, the organization, equipment, staff and partner families. I accept with my signature, as proof of agreement and willing compliance.

I have attached a completed Release and Waive of Liability for the current year.