Volunteer Application Form - Today's Harbor for Children

Thank you for your interest in becoming a volunteer. You must complete the entire form for consideration. Please complete and return the Volunteer Acknowledgement form to: Today’s Harbor for Children, 514 Bayridge Rd. La Porte, TX 77571 Phone: 281-471-9622 Fax: 281-471-4396

Click here to complete and sign a pdf version to sumbit via fax, email, or postal mail.

Volunteer Acknowledgment

PLEASE COMPLETE THIS FORM

FULL NAME*
ADDRESS*
CITY/STATE/ZIP*
HOME PHONE*
WORK PHONE
CELL PHONE
EMAIL ADDRESS*
DATE OF BIRTH*
SOCIAL SECURITY NUMBER*
Please enter a number from 0 to 9999999999.
DRIVERS LICENSE STATE OF ISSUANCE*
DRIVERS LICENSE OR ID#*
EMPLOYER
OCCUPATION
EMPLOYER ADDRESS
DOES YOUR COMPANY OFFER A MATCHING FUND OR COMPANY CONTRIBUTION FOR YOUR VOLUNTEER SERVICE
- Yes
- No
IF YES, PLEASE GIVE NAME AND PHONE NUMBER OF THAT PERSON
ARE YOU A MEMEBER OF ANY CHURCH OR RELIGIOUS OR CIVIC ORGANIZATION? IF SO, WHICH ONE?
HOW DID YOU LEARN ABOUT OUR VOLUNTEER PROGRAM?
ARE YOU VOLUNTEERING TO FULFILL A PROFESSIONAL REQUIREMENT?
- Yes
- No
ARE YOU VOLUNTEERING TO FULFILL A CLASS REQUIREMENT OR SEEKING AN INTERNSHIP?
- Yes
- No
IF YES, HOW MANY HOURS DO YOU NEED TO COMPLETE, AND BY WHEN?
WHEN ARE YOU ABLE TO VOLUNTEER? (PLEASE INDICATE DAY(S) AND TIME(S) AVAILABLE)
WHAT TYPE OF VOLUNTEER WORK ARE YOU INTERESTED IN?
ARE YOU INTERESTED IN VOLUNTEERING AT THE ADMINISRATION OFFICES OR OUR CAMPUS?
PLEASE LIST ANY SPECIAL SKILLS YOU HAVE
PLEASE LIST 3 PERSONAL REFERENCES, WHICH ARE NOT RELATED TO YOU, BUT HAVE KNOWN YOU FOR AT LEAST ONE YEAR. PLEASE PROVIDE A COMPLETE NAME, ADDRESS (INCLUDING ZIP CODE), AND PHONE NUMBER FOR EACH INDIVIDUAL YOU LIST.*
SIGNATURE*
DATE*

* The information obtained in this application is for internal use by Today’s Harbor for Children only.

* Today’s Harbor for Children will conduct a criminal background check and by signing this application you give us permission to complete this portion of the volunteer screening process.

* Volunteers assume the responsibility of asking any and all questions for clarification.

* Volunteers are required to maintain confidentiality at all times during their volunteer assignments.

PLEASE COMPLETE THIS FORM

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