Step 1 of 6 - Personal Information 0% Personal InformationName(Required) First Last What are your pronouns?Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone(Required)Email(Required) What is your age?(Required) 18+ years 13-17 years 11-12 years (requires accompanying adult) If under 18 years of age, please provide your birthdate:(Required) DD slash MM slash YYYY To volunteer you must be at least 13 years old. If you are 11 or 12 years old, you can only volunteer with an accompanying Adult Volunteer.Accompanying Adult VolunteerIf 11 or 12 years old, you will require an adult who is a registered Hillel Lodge Volunteer to accompany you, please provide their name and contact information above. About MeAre you a student?(Required) Yes No Other Please list Name of School and Current Grade / Year(Required)Is this placement contributing to your community service hours?(Required) Yes No Have you volunteered before?(Required) Yes No If yes, please provide the following information about your last 2 volunteer jobs:(Required)- Name of Role / Organization: - Number of Years Service: - Reason for Leaving:Are you currently employed?(Required) Yes No If yes, please provide the following information about your current job:(Required)- Position / Title: - Employer:Do you speak, read or write in any languages, other than English?(Required) Emergency ContactName(Required) First Last Primary Phone Number(Required)Secondary Phone NumberEmail Address Mailing Address if different from applicant: Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Relationship to applicant(Required) Volunteer Interests & AvailabilityMany factors are considered when matching volunteers to a role, including your availability, interests, and skills as well as the current available opportunities in the Lodge.Availability(Required) Days Evenings Weekends Weekly Biweekly Monthly Other Other Availability(Required)Specific Areas of Interest - RECREATION (please check all that apply)(Required) Friendly one-to-one visits with residents Residents' group activities support Escorting residents to and from activities Group outings support Pet visits Entertainment Mobile Library Program Palliative Care/End of Life (training required) Administrative support Other Other Areas of Interest - RECREATION(Required) ReferencesPlease provide 2 references of people who have knowledge of your background, skills and abilities:Reference #1 - Name, Relationship, Phone, Email(Required)Reference #2 - Name, Relationship, Phone, Email(Required) Volunteer Application AttestationI certify that the information in this application is correct and complete. I understand that there will be a three month probationary period and no reference will be given before that time. I understand that attendance at a general orientation is mandatory. I understand that if I am under the age of eighteen (18) I must have my parent/guardian give and sign for permission to volunteer at Hillel Lodge. While we try to place qualified volunteers, we reserve the right to select applicants according to our needs and criteria.Please type your Full Name to acknowledge the above statement.(Required)Today's Date(Required) DD slash MM slash YYYY
