Neighbors Helping Neighbors Volunteer Application Home 9 Neighbors Helping Neighbors Volunteer Application Please complete the form below: Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastGender *AddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeAre you a legal resident of the United States: *YesNoEmail *PhoneEmergency Contact Name *Emergency Contact Phone *Skills & Other QuestionsLevel of Education *Career Occupation *Languages you speak *How did you find out about us? *Please share your reasons for wanting to volunteer *Do you have any previous work volunteering? Please explain *What are your interests and/or skills *Do you have any physical limitations *Are you comfortable meeting with a client in their home? (A staff member will always join you at the initial visit) *YesNoWhat is your computer experience? Check all that apply *EmailSocial MediaInternet searchMicrosoft WordMicrosoft ExcelAre you comfortable using a laptop or computer to complete applications? *YesNoAvailability Please select your time preferences on the days you are available AM = Before Noon PM = noon - 5p.m. Any = Available AM or PM Neither = Not available that dayMonday *AMPMAnyNeitherTuesday *AMPMAnyNeitherWednesday *AMPMAnyNeitherThursday *AMPMAnyNeitherFriday *AMPMAnyNeitherAre you prepared to complete 8 hours of training? *YesNoAre you prepared to attend the once a month support meeting? *YesNoDoes your schedule permit you to attend meetings during the work day? *YesNoCan you commit to be a volunteer for at least one year? *YesNoReferencesReference 1: Name *Reference 1: Phone *Reference 1: Email *Reference 2: Name *Reference 2: Phone * you be all Reference 2: Email *Reference 3: Name *Reference 3: Phone *Reference 3: Email *Background Check *Yes, I understandI understand that a background check is required for all potential volunteers and that before becoming a volunteer I will need to provide additional details (social security, date of birth, vehicle model, driver's license #) to Logan Health so that a background check can be performed.Submit
