PRISM Volunteer Application Thank you for your interest in volunteering! Please complete this application. Once submitted, your application will be reviewed and someone from PRISM will contact you. Thanks! OK Question Title * 1. Today's Date Select today's date Date OK Question Title * 2. Name (First, Last) OK Question Title * 3. Suffix OK Question Title * 4. Volunteer is: Older than 18 years 16-18 years old 12-16 years old OK Question Title * 5. Address Address Address 2 City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Email Address Phone Number OK Question Title * 6. Emergency Contact Name OK Question Title * 7. Emergency Contact Phone Number OK Question Title * 8. Emergency Contact's Relation to You OK Question Title * 9. For the safety of our clients, volunteers, and staff, PRISM requires all potential volunteers to disclose any misdemeanor or felony convictions they have had. PRISM may run a criminal background and/or drivers license check on applicants who wish to work directly with our participants. Do you have any misdemeanor or felony convictions? No Yes If yes, list the year and charges OK Question Title * 10. Ethnicity/Race Native American Asian / SE Asian / Pacific Islander African American Native Hawaiian or Other Pacific Islander Caucasian / White Hispanic / Chicano / Latino Other Prefer not to answer OK Question Title * 11. Do you belong to one of PRISM's Faith Partners? No Yes If yes, which Faith Partner? OK Question Title * 12. How did you hear about PRISM? OK Question Title * 13. Are you employed? No Yes If yes, write the name of your employer. OK Question Title * 14. Does your employer match employee donations for charitable organizations? Yes No Not employed OK Question Title * 15. Are you willing to be called if we are short-staffed? Yes No OK Question Title * 16. Primary Language OK Question Title * 17. Proficient Languages OK Question Title * 18. Please check all areas of interest in these ONGOING OPPORTUNITIES Food Shelf: Assisting participants with shopping Food Shelf: Sorting and organizing food Food Shelf: Picking up donations from grocery store partners Thrift Shop: Working cash register / bagging in the shop Thrift Shop: Creating displays in the shop Thrift Shop: Sorting and organizing clothing, household items, etc. Front Desk: Reception (answering phones, greeting participants/volunteers) Front Desk: Clerical (Filing, copying, other tasks as needed) Front Desk: Data entry Boards and Committees: Board of Directors (governance and policy making) Board and Committees: Faith Partners (congregation liaison for events, drives, initiatives) OK Question Title * 19. Please check all areas of interest in these PERIODIC OPPORTUNITIES Building Care (cleaning and maintenance) Birthday Room (restocking toys and maintaining tidiness) Library Management (sorting and stocking books) Event Assistance (before and during an event) Photographer Ambassador / Tabling (representing PRISM at community events) Back-to-School Success Program (seasonal program in August) Holiday Toy Shoppe (seasonal program in December) Other: OK Question Title * 20. Indicate Your Food Shelf Availability Monday – 8:30 AM - 12:30 PM Monday – 12:00 PM - 4:30 PM Tuesday – 8:30 AM - 12:30 PM Tuesday – 12:00 PM - 4:30 PM Wednesday – 8:30 AM - 12:30 PM Wednesday – 12:00 PM - 4:30 PM Thursday – 8:30 AM - 12:30 PM Thursday – 12:00 PM – 5:00 PM Thursday – 5:00 PM – 7:30 PM OK Question Title * 21. Indicate Your Front Desk Availability Monday – 8:30 AM - 12:30 PM Monday – 12:00 PM - 5:00 PM Tuesday – 8:30 AM - 12:30 PM Tuesday – 12:00 PM - 5:00 PM Wednesday – 8:30 AM - 12:30 PM Wednesday – 12:00 PM - 5:00 PM Thursday – 8:30 AM - 12:30 PM Thursday – 12:00 PM - 5:00 PM Thursday – 5:00 PM - 7:30 PM Friday – 9:00 AM - 1:00 PM (Food Shelf Closed) Friday – 1:00 PM - 5:00 PM (Food Shelf Closed) OK Question Title * 22. Indicate Your Thrift Shop Availability Monday – 9:00 AM - 1:00 PM Monday – 1:00 PM – 5:00 PM Tuesday – 9:00 AM - 1:00 PM Tuesday – 1:00 PM – 5:00 PM Wednesday – 9:00 AM - 1:00 PM Wednesday – 1:00 PM – 5:00 PM Thursday – 9:00 AM - 1:00 PM Thursday – 1:00 PM – 5:00 PM Thursday – 4:00 PM – 7:00 PM Friday – 9:00 AM - 1:00 PM Friday – 1:00 PM – 5:00 PM Saturday – 9:00 AM – 12:30 PM Saturday – 12:00 PM – 3:00 PM None OK Question Title * 23. Additional Comments OK Question Title * 24. Signature OK Question Title * 25. Date Date / Time Date OK DONE