Hebron House of Hospitality Volunteer Application

Contact Information Name Street Address City ST ZIP Code Home Phone Work Phone E-Mail Address Gender ____Male ____Female Date of Birth

Frequency Date/Times: Please let us know the days of the week that will work best (or a specific date) and a time that works best! Thank you.

___ One Time Event Date: ______Time:______Once a Month Days:______Time:______Quarterly Days:______Time:______Other, please specify Days:______Time:______

Interests Tell us in which areas you are interested in volunteering, we will try and accommodate everyone based on our shelter’s needs! Thank you. ___ Meal Preparation and/or Dining with guests ___Breakfast ___Dinner ___ Bringing Dessert (Ice Cream Bar/Other Snacks) ___Planning a special night at one of the shelters (pizza night, movie night, trivia/game night, etc) ___ Share a special talent with the guests (baking, sewing, organizing, jewelry making, scrapbooking, nutrition, etc.) ___ Holding a Fundraiser- bake sale or car wash to raise money for a project (Food for the shelters, playground, clothing) ___ Collection/Drive for cleaning supplies ___ Cleaning/Maintenance around Shelters ___Committee Team (Helping organize one of our events with a team!) ___ Painting (Must be 18 or accompanied by an adult.

 Providing: ___Paint ___Bucket ___Brushes ___Ladders ___Extension Poles ___Drop Cloths ___Rollers ___Rolling Heads Administrative Office: 111 E Main Street, Waukesha, WI 53186 (P) 262-522-1406 ~ [email protected] ~ www.hebronhouse.org ___ Other, please specify: ______

Special Skills or Qualifications Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.

How did you hear about us? ___Family/Friend/Neighbor ___Church/Civic Group/ School ___Hebron House Website ___Volunteer Center Website ___Other: ______

Criminal Background Have you ever been convicted of a crime? ___Yes ___No Have you ever been accused of child neglect or abuse? ___Yes ___No Do you use illegal drugs? ___Yes ___No Have you utilized our shelter/services within the last 6 months? ___Yes ___No Are you volunteering to fulfill court ordered community service? ___Yes ___No If Yes, How many? ______

Agreement and Signature By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

Our Policy Waiver: I know that volunteering for the Hebron House of Hospitality, Inc is a potentially hazardous activity. I should not volunteer unless I am medically able. I agree to abide by any decision of Hebron House of Hospitality, Inc staff to safely complete my volunteer project. I assume all the risks associated with volunteering for the Hebron House of Hospitality, Inc. Having read the waiver and knowing those facts and in consideration of your accepting my application, I and anyone else entitled to act on my behalf, waive and release Hebron House of Hospitality, Inc, of all their subsidiaries and sponsors, their representatives and successors for all claims in liabilities of any kind arising out of my volunteering. I grant permission to all of the foregoing to use any photographs, motion picture recordings, quotations or any other records of this event for any legitimate purpose.

It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability. Thank you for completing this application form and for your interest in volunteering with us. PLEASE NOTE: The Hebron House of Hospitality, Inc reserves the right to run a background check on each volunteer applicant. The Hebron House of Hospitality, Inc. requires that all minors interested in volunteering do so with parental permission. If the applicant is under age 18, please have a parent or legal guardian sign below. (Please note that minors younger than highs school age will need to be accompanied by an adult.)

Name (printed) Signature Name of Employer (For Grant Opportunities) Date

Administrative Office: 111 E Main Street, Waukesha, WI 53186 (P) 262-522-1406 ~ [email protected] ~ www.hebronhouse.org