One moment please...

Volunteer Application

Contact Information



Skills and Interests:


Personal Data

**We will need a copy of a government issued ID (such as a driver's license).

If you have a digital copy of your government issued ID, you may upload it here.


List the names, addresses, phone numbers, and email addresses (if applicable) of three personal references, other than relatives:

Client Confidentiality/Protection Pledge/Emergency Treatment

Please read the following statement carefully:

Maintaining the confidentiality of the residents of Providence House and their families is of the utmost importance. As a volunteer, you will be expected to abide by this organization's policy to protect the confidentiality of those who live here. In agreement with this policy, I pledge to honor the privacy and uphold the confidentiality of each resident/child at Providence House. Providence House reserves the right to obtain a criminal background and social security number check. If I should become ill/injured, I authorize Providence House to arrange emergency treatment and I accept responsibility for payment of medical services rendered. 

Please type your name as your digital signature.