Basic Information Name *
Example: She/her; he/him; xe/xem
Phone * Address
Date of Birth *
Safe Haven volunteers must be over 18 years old for certain tasks.
Who is your employer and what is your title? Is your volunteer time a requirement for a class or other community service? * Required Volunteering
Note that becuase of the shorter time-frame that comes with these types of volunteer experiences, volunteers that are completing hours for a class will not have direct client or youth contact.
School/Program Name * Instructor/Supervisor's name, title, contact information * How many total hours are required? * Required completion date Volunteer Availability
In general, what time(s) would you be primarily available to volunteer? NOTE: Priority is given to those that can volunteer Monday-Friday 8am-4pm.
Monday Tuesday Wednesday Thursday Friday Saturday Sunday Can you commit to volunteering at a regular scheduled time? Yes No Background, experience, knowledge, skills and interests Why would you like to volunteer with Safe Haven? * List any skills, training or experience you would bring to this volunteer opportunity. * Have you or an immediate member of your family received services from Safe Haven in the last 24 months? * Yes No Unsure Have you ever been convicted of a misdemeanor or a felony? * Please provide dates and nature of crime. Volunteer Interest
Let us know your interest in different volunteer activities.
Cleaning Organizing Dinner Service Child Care Event Fundraising If you have a special talent that you would like to share, let us know here: Reference Check
Some of our volunteer positions have the potential of client interaction, because of that, we will need some references if/when you end up volunteering in those roles.
Relationship * Relationship * Email *
Phone * Phone * Name *
Relationship * Email *
I fully understand that misrepresentation or omission of facts called for in this application is cause for dismissal. I understand that to ensure the safety of clients, it is the policy of Safe Haven Shelter and Resource Center to complete a background and reference checks on all potential volunteers and acceptance into the volunteer program is contingent upon its satisfactory completion.
I give Safe Haven Shelter and Resource Center consent/permission to contact my references.