EmailMe Form - Iris Volunteer Application

Name

First Last

Email

Birthday

Phone

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

Social security number:

Driver's License #:

State Issued:

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Have you ever been convicted of any criminal offenses?

If yes, please explain:

Have you ever been accused of or charged with child abuse or neglect, domestic violence, or a sex crime?

If yes, please explain:

Have you ever been a resident at Iris?

Do you know anyone currently living in the shelter?

Work & Education Experience

Are you currently a student?

If yes, what school:

Anticipated date of graduation:

Major/Minor:

Please list schools attended and degree(s) earned:

Current (or last) employer:

Dates employed:

Please list any agencies and dates of previous volunteer work or community involvement:

References (Professional or Personal):

Name

First Last

Phone

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

Email

Name

First Last

Phone

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

Email

Additional Questions:

Why do you want to volunteer at Iris?

How did you hear about Iris?

Are you Bilingual?

Yes

No

If yes, what additional languages do you speak?

Emergeny Contact:

Name

First Last

Phone

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

Relationship:

Name

First Last

Phone

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

Relationship:

Please check volunteer opportunities that interest you:

Administrative & Projects (Donation pick up, event planning, data entry)

Education and Training Program (health fairs, community education)

Legal Services (court advocacy, protective order hearings)

Community Engagement (updating/verifying resources available)

Clinical Services (facilitating support group for survivors)

Crisis Call-Out Services (medical advocacy with survivors)

Enrichment Services (career or life skills workshops)

Children's Program (tutoring, play group, special events)

NOTE: A background check and 40 hours of training are required for all volunteers.

Upload Resume (if applicable):