Volunteer/Intern Application

Name: __________________________________ Date of Birth: ________________

Address:__________________________________________________

City: _____________________________________________________

State: ___________ Zip: ________________

Home Phone #: ______________________ Other Phone #: ______________

Email address:_________________________________________________

Occupation/Employer:________________________________________________________________
Interests, skills, hobbies:_________________________________________________
___________________________________________________________________________________
Have you ever done volunteer work before? _______

Where?_____________________________________________________________

What kind?___________________________________________________________

What kind of volunteer work would you like to do?
□ Answer Phones □ Fundraising □ Presentations □ Transportation □ Clerical
□ Maintenance □ Special Projects □ Tutoring □ Running Errands □ Staffing the shelter
□ Other______________________________________________________________
How much time can you give? Weekly: _________ Monthly: __________

Available times: _______________________________________________________

Why do you wish to volunteer for Crossroads Shelter?

___________________________________________________________________

___________________________________________________________________

Where did you hear about us?

_________________________________________________________

Name, address, and phone # of a personal reference:
______________________________________
______________________________________
_____________________________________________

Other information you wish to share about your talents or interests (use back of paper, if needed):