Family House



Volunteer workers at Christmas

Volunteer Application

Thanks for taking the time to contact us.

Volunteers:
Feel free to call or email us. We will respond to all inquiries in a timely manner.

Telephone: (415) 476-0160

Supporters:
Use the form below to receive more information about how to get involved. Thank you for your support.

Telephone: (415) 476-8321

Volunteer Application

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Use the form below to receive more information about how to get involved. Thank you for your support..

Fields marked red are required.

Email: Allow us to contact you via Email?

	Yes		No

Name: Address: City: State: Zip: Country: Home Phone: Work Phone: Cell Phone: Are you over 18?

	Yes		No

Birthdate: How long have you lived in California: Have you ever pled guilty or no contest, or have you ever been convicted of a crime involving theft, sexual misconduct or violence?

	Yes		No

How did you find out about Family House?: Why do you want to become a volunteer at Family House?: What areas are you interested in?:

	House Support
	Office Support
	Fundraising Support
	Gardening
	Maintenance
	Baking/Cooking
	Direct Assistance to Clients
	Committee work
	On-Call Assistance
	Computer work

Do you have any previous volunteer experience? (If yes, please describe): Do you have any special skills or training that might benefit Family House?: Do you have any prior experience working with critical or terminal illnesses?: Do you speak a foreign language? Which?: What are your hobbies?:

Please list two people who will give a character reference for you:

#1 Name: #1 Phone: #1 Relationship: #1 Know how long: #2 Name: #2 Phone: #2 Relationship: #2 Know how long:

Are you available to volunteer on weekday?

	Yes		No

Are you available to volunteer on weekends?

	Yes		No

Are you willing to make a three month commitment to Family House?

	Yes		No

People to contact in case of emergency:

#1 Name: #1 Phone: #1 Relationship: #2 Name: #2 Phone: #2 Relationship:

Please add any information you would like us to know about you: Questions/Comments: