Vol Application

MENTOR

COUNSELING

LIFE SKILLS

VOLUNTEER

SOTM. Inc.

Volunteer Application

Supporting Others Through Mentoring

"Rebuilding lives since 1993"

Please complete this application form if you are interested in becoming an volunteer. Once you complete the form, click the submit button at the bottom. Thank you for making a difference

Name

Street Address

City

State/Province

Zip/Postal Code

Work Phone

Home Phone

Cell Phone

E-mail

Demographic Information
Please provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers for grant purposes only.

Date of birth: *

Age range: Youth ages 16 and up volunteer opportunity also available.

Gender: *

Ethnicity: *

T-shirt or Polo Shirt size:

Church Home.:

How did you hear about us?

Share one thing about yourself:

Availability
Please indicate the days and times you are usually available to volunteer.

Sun Mon Tue Wed Thu Fri Sat

From:

To:

My availability is:

From:

to:

Skills:

Accounting Administrative Life Skills Coach

Singing Public Speaker Counselor

Educator Engineering Graphic Arts

Health Care Professional Web Designer Horticulture

Bi-lingual Outdoor Sports Photography

Computer Theatre

Assignment Preference:

Group Leader, Co-Leaders, Facilitator, Encourager, Supporter,

Administrative help, Office Asst. Phone volunteer

Public Relations, Speakers,

Client Support, Mentor, Coach, Peer Counselor

Marketing, Newsletter, Corporate office, Fund Raiser

Email Preferences
We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.

What kinds of email would you like to receive?

Electronic newsletters
This is a quarterly newsletter that keeps you updated on events staff and with other volunteers.

Recruitment Appeals
These are requests for help with special events such as workshops, seminars, New groups

Training Announcement
These are announcements of scheduled Training Sessions for Volunteers.

Opportunity Announcements
These are new volunteer opportunities openings

General Information
These are general type information to keep you informed with things concerning SOTM, Inc. Any other information to keep you aware of SOTM Community involvement.

Schedule Reminders
This is an automatic reminder of when you are scheduled to work.

References
Enter the names and telephone numbers of two references that are not related to you and are not previous volunteer supervisors.

1 2

First name: * First name: *

Last name: * Last name: *

Home phone: * OK to call here Home phone: * OK to call here

Work phone: OK to call here Work phone: OK to call here

Cell phone: OK to call here Cell phone: OK to call here

Other phone: OK to call here Other phone: OK to call here

Email address: Email address:

Relationship: * Relationship: *

Skills & Experience

Education:

Middle/High School:

College:

What do you personally hope to gain?

What organization have you volunteered with?

Emergency Contact

1 2

First name: * First name: *

Last name: * Last name: *

Street 1: Street 1:

Street 2: Street 2:

City: City:

State: State:

Zip: Zip:

Home phone: * OK to call here Home phone: * OK to call here

Work phone: OK to call here Work phone: OK to call here

Cell phone: OK to call here Cell phone: OK to call here

Other phone: OK to call here Other phone: OK to call here

Email address: Email address:

Relationship: * Relationship: *

Employer Information

Employer name:

Work phone: OK to call here

Background Check
(Please note: Some Volunteer Positions may require a background check we may ask for Drivers license number and social security number. However we will do so in writing and confidentially.)
I hereby grant SOTM, Inc. and its authorized representatives at any time during my application for volunteering authority to conduct an inquiry into my criminal record. I understand that as a part of this inquiry a driving record and credit check may be conducted. I release from liability all persons, companies, schools, and corporations supplying such information, and hold harmless SOTM Inc. and its representatives from any and all liability resulting from the background inquiry.

I Agree

Name
Street Address
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
Cell Phone
E-mail

Date of birth:	*
Age range:	Youth ages 16 and up volunteer opportunity also available.
Gender:	*
Ethnicity:	*
T-shirt or Polo Shirt size:
Church Home.:
How did you hear about us?
Share one thing about yourself:

	1		2
First name:	*	First name:	*
Last name:	*	Last name:	*
Home phone:	* OK to call here	Home phone:	* OK to call here
Work phone:	OK to call here	Work phone:	OK to call here
Cell phone:	OK to call here	Cell phone:	OK to call here
Other phone:	OK to call here	Other phone:	OK to call here
Email address:		Email address:
Relationship:	*	Relationship:	*

What do you personally hope to gain?
What organization have you volunteered with?

Author information goes here.Copyright © 2003 [OrganizationName]. All rights reserved. Revised: 07/06/11

Author information goes here.
Copyright © 2003 [OrganizationName]. All rights reserved.
Revised: 07/06/11