Volunteer Application

Name and Address

First & Last Name:

Date of Birth:

Address:

City:

State:

Zip:

Email:

Home phone:

Work phone:

Cell phone:

Fax:

SSN*:

*Your social security number is necessary in order to work with protected species. If you are not comfortable submitting this here, you can contact Diane Johnson, executive director of OWL, with this directly.

Education:

Disabilities:

Date of last tetanus shot:

Medical Conditions including Allergies:

Emergency Contact Information

Name:

Phone:

Relation to you:

Have you ever been convicted of a felony? No Yes

If yes, what for?

References

Employment Reference

Name:

Address:

City:

State:

Zip:

Daytime phone:

Personal Reference (non-relative)

Name:

Address:

City:

State:

Zip:

Daytime phone:

Preference

What type of volunteer position interests you? See full position descriptions.

Facility Center Staff
Receiving Center Staff (must be 18 years old)
Home Rehabilitation Staff (must complete 2 year apprenticeship at main facility)
Transport Staff
Housekeeping Staff
Internship (accepting only spring/summer interns)
Other - Please Explain:

How did you hear about this volunteer opportunity?
(please be specific)

Availability and Experience

When are you available? (i.e. 1st shift, 2nd shift, evenings, weekends, etc)

What special skills, interests or hobbies do you have which might be useful working for OWL?

Paid work experience (List type of work and organization names.)

Why do you want to volunteer at OWL?

What would you like to get out of your volunteer experience at OWL?