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* 1. Name

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* 2. Address

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* 3. Email

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* 4. Best phone number to reach you at

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* 5. Date of Birth
(Volunteers must be at least 16 years of age.)

Date

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* 6. Areas of Interest:

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* 7. At which Sheltering Arms center are you interested in volunteering?
(If you're unsure what center is closest to you, click here to see a map of our centers.)

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* 8. What days are you interested in volunteering?

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* 9. What time of day are you available for volunteering?
Volunteer opportunities are available from 9:00 am - 12:00 pm and 2:30 pm - 5:00 pm.)

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* 10. How often do you plan on volunteering?

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* 11. Other than traffic violations, do you have any criminal convictions?

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* 12. If yes, please provide more information:

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* 13. Are you able to perform the essential functions of the volunteer assignment, with or without a reasonable accommodation?

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* 14. Accommodation desired, if applicable:

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* 15. Do you speak any languages other than English?

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* 16. If yes, please specify what languages:

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* 17. Do you have previous volunteer experience?

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* 18. If yes, please list where you have volunteered at previously and what you did in that volunteer position:

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* 19. Do you have any of the following?
(Please select all that apply)

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* 20. Do you have any special skills, interests, or qualifications that we should know about?

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* 21. Place of worship? 
(This is asked because many faith-based grant programs request if there are volunteers from their organization.)

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* 22. Please let us know if you have any other questions, comments or concerns:

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* 23. Emergency Contact:
(The person we contact in case of an emergency)

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* 24. I certify that the information listed on this form is complete and correct.

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