Section I. - Contact

Your Name (required)

Address (required)

City (required)

State (required)

Zip Code (required)

Phone (required)

Your Email (required)

Section II. Education and Expereince

Previous Volunteer Experience

Occupation (past occupation is retired)

Other information that will help us make a good match (education, general interest/hobbies)

Languages spoken besides English

Section III - Availiablity

Availability (Please check all that apply)

I am available on the follow days:

MondayTuesdayWednesdayThursdayFridaySaturdaySunday

I am available during the following times:
MorningsAfternoonsEvenings

I am committed to volunteering:
One time onlyAs neededOther (please explain)

Section IV - Interests

What areas you most interested in serving? (please check all that apply)
Administrative SupportMentoringtutoringInternshipsCareer CoachingBeautification ProjectsServing/Sponsoring MealsHosting a Donation DriveSponsoring Small EventsSponsoring a WorkshopHelping with an CHW Annual EventOther (please explain)

Other

Section V. Background and Refrences

Have you ever been convicted of a crime?
NoYes

if yes, please provide dates and details of the situation

Please provide at least 3 personal or professional references:

Reference 1

Name

Phone

Email

Reference 2

Name

Phone

Email

Reference 3

Name

Phone

Email

Section VI. - Acknowledgement/Policies

Forms to read and acknowledge:

• Social Media Code of Conduct
• Code of Conduct
• Individual Volunteer Policy

I have read the above policies and understand the risks involved in being a volunteer for Covenant House Washington. I further understand that Covenant House Washington will not assume any financial liability for any injury or illness that I, or any member in attendance with me, might incur while performing voluntary service for Covenant House Washington.