Individual Volunteer Application

Name: *

First

Name: *

Last

Email: *

NOTE: By submitting the volunteer application you are agreeing to receive occasional electronic newsletters regarding volunteer opportunities at Christ House.

Phone Number: *

Address: *

Apt. Number (if necessary):

City: *

State: *

Postal Code: *

Date of Birth (MM/DD/YYYY): *

Church or Group Affiliation (if any):

Employer and Occupation:

Other Languages Spoken:

Would you like to receive occasional printed mailings from Christ House?

Yes

Note: Christ House will not sell, trade, or give your email or mailing address to anyone at any time.

Would you like to receive occasional electronic newsletters from the development team at Christ House?

Yes

Note: Christ House will not sell, trade, or give your email to anyone at any time.

Volunteer Opportunities (Note: Please mark your interest in the volunteer opportunities below)

Meal preparation, serving, and clean-up in the kitchen and dining room

Phone relief receptionist during evenings, weekends, and/or holidays at the nurses' station

Accompanying patients to and from medical appointments during regular business hours

OtherOther

Note: Please check the Individual Volunteer section of the website to see a brief description of the volunteer opportunities at Christ House.

Sunday Availability (Note: Please mark your availability.) *

Breakfast: 7:00AM-9:00AM

Lunch: 11:00AM-1:30PM

Dinner: 5:30-7:00PM

OtherOther

Not Available

Options listed are based on current openings. Sunday openings in the kitchen depend on rotating meal groups already scheduled.

Monday Availability (Note: Please mark your availability.) *

Breakfast: 7:00AM-9:00AM

Lunch: 11:00AM-1:30PM

Nurses' Station: 6:00PM-8:00PM

OtherOther

Not Available

Options listed are based on current openings.

Tuesday Availability (Note: Please mark your availability.) *

Breakfast: 7:00AM-9:00AM

Lunch: 11:00AM-1:30PM

Nurses' Station: 6:00PM-8:00PM

OtherOther

Not Available

Options listed are based on current openings.

Wednesday Availability (Note: Please mark your availability.) *

Breakfast: 7:00AM-9:00AM

Lunch: 11:00AM-1:30PM

Dinner: 5:30PM-7:00PM

Nurses' Station: 6:00PM-8:00PM

OtherOther

Not Available

Options listed are based on current openings.

Thursday Availability (Note: Please mark your availability.) *

Breakfast: 7:00AM-9:00AM

Lunch: 11:00AM-1:30PM

OtherOther

Not Available

Options listed are based on current openings.

Friday Availability (Note: Please mark your availability.) *

Breakfast: 7:00AM-9:00AM

Lunch: 11:00AM-1:30PM

Dinner: 5:30PM-7:00PM

OtherOther

Not Available

Options listed are based on current openings.

Saturday Availability (Note: Please mark your availability.) *

Breakfast: 7:00AM-9:00AM

Dinner: 5:30PM-7:00PM

OtherOther

Not Available

Options listed are based on current openings. Saturdays are our busiest days for volunteers. Open shifts in the kitchen depend on rotating meal groups already scheduled. General openings occur the 1st Saturday of the month for breakfast and the 3rd Saturday of the month for dinner.

Do you need special accommodations? Do you need special accommodations?

If yes, please elaborate. Please note that Christ House welcomes anyone regardless of ability, but due to the nature of our facility and staff we may be unable to accommodate all needs.

Do you need to fulfill a service requirement? Do you need to fulfill a service requirement?

If yes, please indicate how many hours, your deadline, and who is requesting this requirement. Please note that Christ House may not be able to accommodate all requests for required service hours.

How did you learn about Christ House?

Please share what draws you to serve with Christ House:

Please list a reference who can speak to your character: (Name, Address, Phone Number and E-mail)

Volunteer Policy on Confidentiality, Waiver and Release

By clicking below, you are acknowledging that you have read and agree to the Christ House Volunteer Waiver and Release above. *

I am aware of the requirements in maintaining confidentiality while volunteering at Christ House and I have read the waiver. I will keep all information observed and heard regarding Christ House patients confidential and I release Christ House from all liability while volunteering.

Individual Volunteer Application

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