Full Legal Name

Date of Birth

Address

City, State, Zip Code

Phone

(###)

###

####

Best Way to Contact

Call

Text

Areas of Service

Meals/Food

Intake/Office

Housekeeping

Overnight

What skills and talents do you have that you would be able to contribute to Open Arms Shelter?

Please describe what experience (if any) you have working with the homeless population.

Why do you want to volunteer at a homeless shelter?

Do you have any physical or mental health concerns that would need accommodation?

Days Available to Volunteer

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Times Available to Volunteer

6:00 AM to 9:30 AM (Morning Shift)

3:00 PM to 6:30 PM (Afternoon Shift)

6:00 PM to 10:00 PM (Evening Shift)

10:00 PM to 6:00 AM (Overnight Shift)

Any available shifts

Other Times (Please specify in notes section).

Do you have reliable transportation?

Yes

Check each box below to confirm the acknowledgements

I will follow all rules, policies & procedures

The director has the final say

I will refrain from alcohol and drug use while on duty

I will give at least 48 hours notice before not being able to keep my shift (exceptions are emergencies)

I will refrain from profanity and will treat all residents and staff with respect

Is there anything else we need to know?

AUTHORIZATION FOR BACKGROUND CHECK*

(Please read and sign this form in the space provided below. Your written authorization is necessary for completion of the application process.)

hereby authorize Open Arms Homeless Shelter to investigate my background and qualifications for purposes of evaluating whether I am qualified for the position for which I am applying. I understand that Open Arms Homeless Shelter will utilize an outside firm or firms to assist in checking such information. I specifically authorize such an investigation by information services and outside entities of Open Arms Homeless Shelter’s choice. I also understand that I may withhold my permission and that in such a case, no investigation will be done and my application for volunteer work will not be processed further.

Signature

Date

YYYY

Thank you! The Director will be in touch with you shortly to arrange a follow-up meeting, tour, and, training.