Volunteer Application

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Date of Birth:*

How old are you?*

Are you 55 or older?*

Hobbies/Expertise/Career Background:*

Do you speak more than one language?*

If so, what language(s)?

Are you familiar with St. Anne's Programs?*

I heard about St. Anne's from:*

I would like to volunteer at St. Anne's because:*

I am interested in helping in one or more of these areas:*

Early Learning Center (clients ages 0-5) - Must be 18 or older. Background Check, TB test, and vaccines required.
Workforce Development Program (clients ages 18-24) - Must be 21 or older. Background check required.
Office/Clerical and Fundraising Events
Thrift Shop (located in Burbank)

Time Available During Weekdays:*

ex. 9:00 AM - 10:30 AM

Time Available during Weekends:

ex. 9:00 AM - 10:30 AM

I would like to volunteer:*

If other, please explain:

Name of Emergency Contact:*

Emergency Contact's Relationship to You:*

Phone Number of Emergency Contact:*

Have you ever been convicted of a crime?*

If so, please explain:

Please note that convictions for certain offenses may bar you from volunteer service with St. Anne's.

I will submit a photo ID, TB test results, vaccination records, and undergo a fingerprinting background check (only if applicable):*

Electronic Signature*