Volunteer Form

First Name *

Middle Name

Last Name *

Address *

City *

State *

Zip Code *

Email Address *

Phone *

Emergency Contact *

Relationship *

Phone *

If time does not permit, I give my consent for Hope Center Houston staff to obtain emergency
medical treatment required for my immediate care.

Initials *

Describe any special skills, training, hobbies, or interests you feel would benefit our organization. *

How did you hear about Hope Center Houston? *

Why do you want to become an HCH volunteer? *

Employment Experience: (Briefly describe)? *

What times are you available to volunteer?

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Are you 18 years of age, or older? *

Yes

No

Except for minor traffic violations, have you ever been convicted of a felony or misdemeanor, criminal offense? (If yes, please explain)

Yes

No

Please Explain *

Please list two, nonrelatives as references, who know your qualities and experiences.

Name *

Email *

Phone

Name *

Email *

Phone

Does your employer have an Employee Volunteer Program? *

If you are willing to list HCH as the recipient of the program, please list corporation name *

For publicity purposes only, can your name and photo be used by Hope Center Houston? *

Yes

No

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Volunteer Application

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