Contact Information

Name                *required

Street             

City                    

State               

Zip Code          *required

Home Phone     *required

Work Phone     

E-Mail Address   *required

When are you available to volunteer?    Anytime Weekday Mornings Weekday Afternoon Weekday Evenings Weekend Mornings Weekend Afternoon Weekend Evenings    (hold control key to select more than one answer)

What are your areas of interest?           Administration Events Field Work Fundraising Deliveries Newsletter production Volounteer Coordination (hold control key to select more than one answer)

Skills, Qualifications, Other Interests   

Previous Volunteer Experience            

What questions do you have?

Agreement & Signature:

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand
that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations
made by me on this application may result in my immediate dismissal.

Check if you agree

Our Policy

It is the policy of this organization to provide equal opportunities without regard to race, color, religion,
national origin, gender, sexual preference, age, or disability.

All volunteer applicants will be required to participate in the following prior to actively volunteering:
• Complete and submit a volunteer application
• Attend an interview with the Executive Director
• Provide 2 forms of ID
• Review our employee handbook

Please be advised the Jason Program reserve the right to run a background check on any and all
volunteer applicants of the Jason Program prior and during active volunteering.

Thank you for completing this application form and for your interest in volunteering with us.