Volunteer Application 1Personal Information2Education3Volunteer Experience4Work Experience5Personal References6Background Questions7Volunteer Work Preferences8Activities & Interests9Acknowledgements Personal InformationName* First Last Phone*Email* Birthday* MM slash DD slash YYYY Who referred you to Wendell Foster? EducationHigh SchoolName of High SchoolYears Attended CollegeName of CollegeYears Attended Degree/Major Other EducationName of SchoolYears Attended Volunteer ExperienceYou may include up to three organizations with which you have volunteered. If you have more than three please choose the most relevant experiences.Organization* Dates of Service* Supervisor* Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Do you have additional volunteer experience to include?* Yes No Organization* Dates of Service* Supervisor* Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Do you have additional volunteer experience to include?* Yes No Organization* Dates of Service* Supervisor* Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*AffiliationsPlease list any charitable, civic, community, educational, religious, or other group affiliations. Work ExperienceYou may include up to three organizations with which you have been employed. If you have more than three please choose the most relevant experiences.Organization* Dates of Service* Position* Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Do you have additional employment experience to include?* Yes No Organization* Dates of Service* Position* Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Do you have additional employment experience to include?* Yes No Organization* Dates of Service* Position* Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone* Personal ReferencesPlease provide three personal references. Do not include relatives.Name* First Last Relationship/Occupation* Phone*Email* Name* First Last Relationship/Occupation* Email* Phone*Name* First Last Relationship/Occupation* Email* Phone* Background QuestionsHave you been convicted of a crime, including misdemeanors, in the last 10 years?* Yes No Please explain.*Have you ever worked with individuals with developmental disabilities before?* Yes No Please explain.*What caused you to become interested in volunteering with Wendell Foster’s Campus?*What can we do to help make you have a positive volunteering experience at Wendell Foster’s Campus?* Volunteer Work PreferencesI am comfortable working in/with…Mark all that apply One-on-one relationships Small groups of people As part of a team I am interested in…Mark all that apply Ongoing activities Short-term projects Special events I am volunteering to fulfill… School/Class observation Community service time N/A Number of hours neededI am currently certified in…Mark all that apply First Aid CPR Other Please explain Please describe your availability*e.g. Weekdays, Weeknights, Weekends; Days & TimesHow many hours are you willing to commit to volunteer?*Per week OR per month Activities & InterestsI am skilled, certified, and/or interested in the following types of activities*Mark all that apply Adaptive Sports (Participation) Adaptive Technology Advocacy Art / Arts & Crafts Board Games Celebrations & Parties (e.g., Birthdays) Community Companion (Weekly Visits) Community Events (e.g., Concerts) Computers / Computer Support Construction, Electrical and/or Plumbing Cosmetics (Hair, Nails, etc…) Exercise & Fitness Fundraising Gardening & Landscaping Holiday Events & Activities Housekeeping Inventory Ladies’ Groups & Activities Letter & Card Writing Magic Maintenance Men’s Groups & Activities Music, Instruments, Karaoke, and/or Dance Nature (e.g., fishing, etc.) Office Work Photography Reading Sewing, Tailoring, and/or Quilting Sign Language Spiritual Care (Chapel, Prayer, etc.) Sports (TV / Live Games) Walking & Talking Video Games Other Please specify other activities AcknowledgementsPlease read and acknowledge the following statements* By checking this box, I acknowledge that Wendell Foster’s Campus requires all volunteers to undergo a TB Skin Test & Volunteer Orientation. I also acknowledge that all volunteers over the age of 16 are required to undergo a Background Check. Finally, if I am approved, I agree to adhere to all volunteer expectations during my time of service. CommentsThis field is for validation purposes and should be left unchanged.