Individual Application

Volunteer Sign Up

Sign up for individual opportunities

Thank you for your interest in volunteering with Status: Home! A staff member of our Volunteer Services will contact you within 72 hours to begin the process of becoming an individual volunteer.

Individual Volunteer Application

Full Name(Required)

Street Address

Street Address Address Line 2 City State ZIP Code

Home Phone

Work Phone

May we call you at work?

Yes

Are you 18 years or older?

Yes

Are you retired?

Yes

Gender?

Male

Female

Email Address

Birthdate

MM slash DD slash YYYY

Current Employer

Employer Address

Street Address Address Line 2 City State ZIP Code

Education Completed

High School

College

Graduate School

Special Skills, Training, or Hobbies

Languages

Spanish

French

Sign for Hearing Impaired

Other

Are you seeking court ordered community service hours?

Yes

How did you hear about our volunteer program and why are you interested in becoming a Status: Home volunteer?

Please check the volunteer role (s) You are most interested in below:

Tutor:
Provides educational support and encouragement to residents of all ages.

Recreation/Playground Coordinator:
Engage youth in positive social interaction through games and fun activities.

Clothes Closet Coordinator:
Sorts and organizes donated clothing and household goods.

Gardening/Landscaping:
Assists with weeding, raking, planting, mowing, and maintaining residential grounds.

Maintenance:
Assists with minor carpentry, painting, and small home repairs for residential facilities.

Resource Assistant:
Works closely with one to two residents to help identify and achieve service plan goals.

Social Activities Coordinator:
Plan/host social activities for residents on or off site such as bowling, concerts, etc.

Special Event Representative/Participant:
Represents Status: Home as a volunteer at a variety of off-site events.

Speaker’s Bureau Member:
Represents Status:Home as a speaker/advocate for agency initiatives.

Please check the day(s) And time(s) You would be available to volunteer.

Monday

Morning

Afternoon

Evening

Tuesday

Morning

Afternoon

Evening

Wednesday

Morning

Afternoon

Evening

Thursday

Morning

Afternoon

Evening

Friday

Morning

Afternoon

Evening

Saturday

Morning

Afternoon

Evening

Sunday

Morning

Afternoon

Evening

Personal References

Reference #1 - Name

Reference #1 - Email

Reference #1 - Address

Street Address Address Line 2 City State ZIP Code

Reference #2 - Name

Reference #2 - Email

Reference #2 - Address

Street Address Address Line 2 City State ZIP Code

Emergency Contact

Full Name

Phone

Consent(Required)

I hereby certify that all information in this application is true and correct to the best of my knowledge. I understand that any falsification or significant omission of any information requested herein will be sufficient cause for discharge without prior warning at any time during my volunteer service at Status: Home. Further, I release Status: Home from any liability based upon information given to them by references named above. If accepted as a Status: Home volunteer, I am willing to follow rules and regulations established by the Board of Directors, including signing confidentiality and sexual policy agreements.

I agree(Required)

Individual Application

Volunteer Sign Up

Sign up for individual opportunities

Individual Volunteer Application

Please check the day(s) And time(s) You would be available to volunteer.

Personal References

Emergency Contact

Your Generosity is Deeply Appreciated

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