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Volunteer Application
I am interested in volunteering at:
*
select one
Cleveland
Columbus
Contact Information
Name
*
First Name
Last Name
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Phone
*
Email
*
Verify Email
*
Current Employer
Employer Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Occupation
Driver's License Number
Date of Birth
*
(mm/dd/yyyy)
Emergency Contact Information
In Case of Emergency, please notify:
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First Name
Last Name
Relationship
*
Emergency Contact Person Phone
*
Education
Name of School Attended
Number of Years Attended or Degree
Course of Study or Major
Name of School Attended
Number of Years Attended or Degree
Course of Study or Major
Please indicate any special skills in which you have been trained/licenses (e.g. RN, Massotherapy, Computers, Hairstylist, etc)
Time Availability (Please check all that apply)
*
Sunday Morning
Sunday Afternoon
Sunday Evening
Monday Morning
Monday Afternoon
Monday Evening
Tuesday Morning
Tuesday Afternoon
Tuesday Evening
Wednesday Morning
Wednesday Afternoon
Wednesday Evening
Thursday Morning
Thursday Afternoon
Thursday Evening
Friday Morning
Friday Afternoon
Friday Evening
Saturday Morning
Saturday Afternoon
Saturday Evening
Events Only
Volunteer Area(s) of Interest (Please check all that apply)
*
Arts & Crafts
Baking
Clerical
Education
Events
Gardening
General Housekeeping
Kitchen (Meal Preparation)
Miscellaneous
RN
Summer Camps
Why do you wish to be a Cornerstone of Hope volunteer?
*
Describe your personal experience with death and loss. Have you experienced any deaths in your family or of those close to you? If yes, please specify the relationship and when they died.
*
Please list any previous volunteer experience:
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Do you have any physical or medical conditions that may limit your ability to participate in certain activities?
*
Have you ever been convicted of a felony?
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Yes
No
References:
Please list one reference, non-relatives, that we may contact to get an understanding of your experience, talents, and character.
Name
*
First Name
Last Name
Relationship
*
How long have you known him/her?
*
Phone
*
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
