Lighthouse Youth & Family Services Volunteer & Intern Application

Transcription

1 Lighthouse Youth & Family Services Volunteer & Intern Application Volunteers are a vital part of Lighthouse, and there s a lot you can do. Give back by investing your time and talent in helping children, youth and families in need. We offer a variety of creative ways you can make a real difference. Daytime, evening, and weekend opportunities are available. Will you help? * Required Volunteer Information 1. I am interested in: * A Volunteer Opportunity An Internship (Field Placement) Opportunity 2. Name * First and Last Name 3. Address - Street, City, State, Zip Code * 4. Phone Number * 5. Phone Number * Cell Phone Home Phone Work Phone 6. Address *

2 7. What is your preferred method of contact? * Telephone 8. Are you at least 21 years of age or older? * 9. Gender Female Male n-binary/third gender 10. Do you have a valid driver's license? * 11. Have you ever been convicted of a misdemeanor or felony? * Please note that failure to disclose a misdemeanor or felony conviction will make you ineligible to volunteer. A conviction will not necessarily bar you from volunteering with Lighthouse Youth & Family Services. 12. If yes, please explain. 13. Are you presently employed? * Skip to question 14. Skip to question 16.

3 Employment Information 14. Employer 15. Job Title Education Information 16. What is your highest level of education? * High school diploma/ged Trade/Vocational School Some College Associate's Degree Bachelor's Degree Master's Degree Doctoral Degree 17. What school did you attend? 18. Do you have any other education or training that may be relevant to your volunteer experience? Availability 19. Please indicate the days and times you are available to volunteer. Morning (9 AM - 12 PM) Afternoon (12-5 PM) Evening (After 5 PM) Monday Tuesday Wednesday Thursday Friday Saturday Sunday Volunteering with Lighthouse Youth & Family Services

4 20. Have you volunteered with Lighthouse in the past? * 21. If yes, in what capacity? 22. How did you hear about Lighthouse Youth & Family Services? * 23. Why are you interested in volunteering with Lighthouse Youth & Family Services? * 24. What expectations do you have as a volunteer? * 25. Please explain any other volunteer/relevant experience.

5 Interests and Skills 26. Please indicate the Lighthouse service area(s) in which you're interested in volunteering. Direct Client Interaction - Youth Ages Direct Client Interaction - Youth Ages Provide and serve meals to clients Tutor students with Emotional Disturbances at Lighthouse Community School Street Outreach Mentor an LGBTQ Youth Age Assist in the Community Garden Administrative Assistance - Reception, Filing, Mailings, Etc. Special Events 27. Please list any additional skills you may be interested in sharing with Lighthouse. Emergency Contact Information Please provide the information for one emergency contact. 28. Emergency Contact Name * 29. Emergency Contact Phone Number * 30. Relationship to volunteer * Family Member Friend Spouse Co-Worker Personal and Professional References Please list three references, including at least one professional/educational reference; exclude relatives.

6 Reference Name, Phone Number, Address, and Relationship to Volunteer * Reference Name, Phone Number, Address, and Relationship to Volunteer * Reference Name, Phone Number, Address, and Relationship to Volunteer * Intern Applicants Only Please complete this section if you're applying for an internship with Lighthouse. Internship and field placement opportunities are available for students enrolled in an accredited college or university who must meet requirements for a field placement or practicum. Lighthouse requires a commitment of at least 100 hours and successful completion of a volunteer application and background check. Those interested in volunteering should skip ahead to the next section. 34. Start Date Example: December 15, End Date Example: December 15, Hours Required 37. Type of Supervision Required

7 38. Do you have any additional requirements? 39. Do you have a specific concentration? Anything else? 40. Please give any other information you feel is pertinent to your application. tice 41. A police and reference check is required for every employee and volunteer of Lighthouse Youth & Family Services. All volunteers providing services on behalf of Lighthouse Youth & Family Services must submit fingerprints for state and federal criminal reports and consent to all pre-placement screenings. Your agreement indicates your approval for us to check references and verifies your understanding of all questions on this application and that the questions were answered accurately and correctly to the best of your knowledge and ability. Lighthouse Youth & Family Services is not obligated to provide a placement, nor are you obligated to accept a volunteer position offered. * I Agree Powered by