Volunteer Application

Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email
What kind of volunteer services/work are you interested in?*
- Clerical
- Direct Advocacy
- Public Speaking
- Organizing Supplies
- Special Events
- Transportation
- Child Care
- On-call
- Undecided
What strengths, skills, or personal characteristics do you believe you have that will help you to do volunteer work with McLeod Alliance?*
Describe your personal social support system*
Are you willing to invest time for the training needed?*
- Yes
- No
Training will be provided for the specific areas in which you will volunteer. Direct advocacy takes at least 4 hours of initial training.
Are you willing to volunteer at least six hours in the first six months following training?*
- Yes
- No
Training is an investment of time from existing staff. Therefore a commitment of volunteer time must be made.
Do you have a valid Minnesota Drivers License?*
- Yes
- No
Drivers License Number
Are you willing to provide the needed information for the background check?*
- Yes
- No
A criminal history background check will be completed for each new volunteer.
Employment/Volunteer Reference
Reference Name
Address
Street Address Address Line 2 City State ZIP Code
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Phone
Type of Work
Personal Reference 1
Name
First Last
Phone
Address
Street Address Address Line 2 City State ZIP Code
Personal Reference 2
Name
First Last
Phone
Address
Street Address Address Line 2 City State ZIP Code
I give permission to contact the persons listed above for references.*
- Yes
- No
By applying for a volunteer position at MAVDV, Inc., I acknowledge that I agree to act in accordance with MAVDV, Inc., ethical guidelines, rules and regulations.
Signature*
Date*
MM slash DD slash YYYY

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Employment/Volunteer Reference

Personal Reference 1

Personal Reference 2