St. Luke Lutheran Community : Volunteer : Volunteer Application

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Volunteer

Volunteer Application

I'd love to help!

Please fill out and submit the on-line form below or contact Cheryl Smith at (330) 497-6145 to begin your rewarding experience at St. Luke Lutheran Community!

Date *REQUIRED*

Last Name *REQUIRED*

First Name *REQUIRED*

Address *REQUIRED*

City *REQUIRED*

State *REQUIRED*

Zip *REQUIRED*

Home Telephone *REQUIRED*

Cell phone

Preferred Response *REQUIRED*

Email
Home Phone
Cell Phone
Mail

Emergency Contact *REQUIRED*

Emergency Phone *REQUIRED*

Education (If currently enrolled, please state grade.)

Highest Education Completed

Elementary *REQUIRED*

High School *REQUIRED*

College

Degree

Foreign Language Training

Read

Speak

Work Experience

Employer (Name, Address, and Telephone)

From

Position

Duties/Responsibilities

Volunteer Experience

Organization

Address

City

State

Zip

From

Duties/Responsibilities

Other

Professional, trade or civic activities or offices held

( You may want to exclude membership which would reveal gender, sex, religion, origin, age, ancestry, disablity or other protected status.)

Describe any specialized training, apprenticeship, skills, and extra-curricular activities

I want to become a volunteer at St. Luke Lutheran Community because *REQUIRED*

Volunteer Scheduling Preferences

Volunteer Interests *REQUIRED*

I prefer routinely scheduled hours *REQUIRED*

I prefer to be to be scheduled for special events only *REQUIRED*

Hours available *REQUIRED*

Days available *REQUIRED*

Physical limitations *REQUIRED*

(St. Luke Lutheran Community does not discriminate based upon limitations.)

Volunteer Signature

(Only required if printed out and mailed in.)

Parent/Guardian Signature for those under the age of 18.

The community service for which my child has volunteered meets with my approval. I release St. Luke Lutheran Community from any liability in connection with his/her duties.

Parent/Guardian Signature

(Only required if printed out and mailed in.)

References (Please list name and address for each)

1 *REQUIRED*

2 *REQUIRED*