Volunteer Application

Today's Date

MM
/
DD
/
YYYY
Name
Prefix
First
Last
Suffix
Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Phone Number

###
-
###
-
####
Email
Date of Birth

MM
/
DD
/
YYYY
(NCAP is only able to accept volunteers who are 18+)
Gender

Emergency Contact

Name
Prefix
First
Last
Suffix
Phone Number

###
-
###
-
####
Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Relationship to you

About you

Besides English, what language do you speak/write?
Are you currently employed?
 Yes 
 No 
If yes, where?
Are you a student?
 Yes 
 No 
If yes, where?
Are you part of a service learning project or completing community service
hours?
 Yes 
 No 
If yes, how many hours do you need to complete?
By what date?
Contact name & number of your case manager/professor
Have you ever been convicted of a felony?
 Yes 
 No 
If yes, list convictions
Do you want to volunteer for a one-time event or on-going?
How many hours would you like to volunteer (per day, week, month, etc.)?

Volunteer Experience

Have you volunteered for NCAP in the past?
 Yes 
 No 
Why do you want to volunteer at NCAP?
What previous volunteer experience do you have?
I would be uncomfortable in the following situations:
What are you interested in doing?
 Front desk/receptionist (answering phones, general office tasks, greeting clients & light cleaning) 
 Transportation (using a NCAP provided vehicle to drive clients to/ from doctor’s appointments, great opportunity to have one-on-one client contact) 
 Food Bank (includes stocking & organizing NCAP’s food bank) 
 Fundraising/ Special Events (usually in evenings and weekends; no set hours) 

Knowledge and Comfort

On a scale of 1 to 10 (1= very low, 10 = very high) how would you rate yourself
on the following?
My knowledge of HIV/AIDS
My comfort level in regard to gay, lesbian, bisexual, and transgender issues
My comfort level in regard to topics of sexuality, safer sex, and sexual practices
My comfort level in regard to drugs and people who use drugs
My comfort level in regard to people who are living with HIV/AIDS or at risk for contracting HIV/AIDS

References

Please provide at least one character reference (not a family member)
Name
Prefix
First
Last
Suffix
Relationship to you
Phone Number

###
-
###
-
####
Name
Prefix
First
Last
Suffix
Relationship to you
Phone Number

###
-
###
-
####

Thank you for filling out this application!

After your application is reviewed, you will be contacted to come in for a short interview. You will then need to complete the volunteer training prior to starting your volunteer service.

NCAP does not discriminate on the basis of age, race, ethnicity, national origin, religion, ability, HIV status, gender identity or sexual orientation.

Questions? Call the Volunteer Coordinator at (970) 484-4469
Image Verification
captcha
Please enter the text from the image:
[Refresh Image] [What's This?]
Powered byEMF Contact Form
Report Abuse