APPLY TO VOLUNTEER (must be 18 years of age or over) Click here for a printable pdf version NAME       Last First Middle Initial ADDRESS         Street City State Zip PHONE PH   BUSINESS PH   CELL PH EMAIL ADDRESS   BIRTHDAY EMPLOYER   POSITION ARE YOU VOLUNTEERING WITH A GROUP? YES NO GROUP NAME? ARE YOU A STUDENT? YES NO WHERE? CHURCH AFFILIATION  ARE YOU BEING REQUIRED TO COMPLETE VOLUNTEER HOURS FOR ANY REASON (SCHOOL, ORGANIZATION, COURT ORDER, HABITAT FOR HUMANITY, SHARE PROGRAM, ETC.?) NO YES, I MUST COMPLETE  HOURS FOR (REASON) EDUCATION/BACKGROUND PREVIOUS VOLUNTEER EXPERIENCE DESIRED FREQUENCY TO VOLUNTEER AT HSHM YEARLY MONTHLY WEEKLY DAILY OTHER Please indicate which area you would like to volunteer in: Children´s Programming Special Events Adopt-A-Meal/Supper Club Adult Programming Warehouse/Rcvng-Sorting Donations Food Preparation Clerical-Office Help Maintenance Meal Server Drives (Food, clothing, etc.) Errand Driver Holiday Meals Other HOW DID YOU HEAR ABOUT VOLUNTEER OPPORTUNITIES AT HOME SWEET HOME MINISTRIES? Friend Advertisement Church Agency Client Staff Member Volunteer Center/School Radio/Television Newspaper/Brochure Other CONTACT IN CASE OF EMERGENCY:     Name   Relationship   Telephone AFFIDAVIT OF CONFIDENTIALITY Home Sweet Home Ministries adheres to the principle of maximum confidentiality and follows the mandates of the Illinois statutes and regulations as from time to time provided, and as currently specified in the Mental Health Confidentiality Act. Accordingly all board members, staff, volunteers, and others associated with the operation of this establishment shall keep all information regarding clients or agency business in general in strictest confidence. I understand the requirements for confidentiality and agree to abide thereby. I further understand that a violation of confidentiality requirements could result in immediate termination of my involvement with Home Sweet Home Ministries, Inc. Date // (mm/dd/yyyy) Ignore this text box. It is used to detect spammers. If you enter anything into this text box, your message will not be sent.