Full Name:

Address:

E-Mail:

Home Phone:

Work Phone:

Birthday:

Do you own a car:    Yes      No

Have a valid driver's license?    Yes      No

Interests:

Why do you wish to volunteer?

What is your previous volunteer experience?


What are your hobbies, skills, special interests?

What is your current or former (if retired) occupation?

If employed, what is your employer's name and address?

Where did you hear about Catholic Charities?


Are there any limitations in the type of work you can do?


Please list highest education attained:

How often are you willing to volunteer? (Indicate the days and times you are available.)


Have you ever been convicted of a crime?    No      Yes
If yes, please explain.


Person to notify in case of emergency. (Include his or her address and phone number.)


References: Please list name, address and phone number of three persons, not family members, who have known you for at least two years.

Date of Application:

Signature: