Volunteer Application

NMI Chapter Volunteer Application

Our Mission: The American Red Cross, a humanitarian organization led by volunteers, guided by its Congressional Charter and the Fundamental Principles of the International Red Cross Movement, will provide relief to victims of disasters and help people prevent, prepare for, and respond to emergencies.

Thank you for your interest and support of the NMI Chapter, The Red Cross respects the confidentiality of the information provided in this application.

Date

Last Name:

First Name:

P.O. Box Number:

City:

Village:

Zip:

Home Phone:

Work Phone:

Cell Phone :

Primary Phone Number:

Home Work Cell

Email Address

Gender:

Male Female

Special Needs?

Yes No

Indicate special needs accomodations:

Availability Mornings

Monday-AM Tuesday-AM Wednesday-AM Thursday-AM Friday-AM Saturday-AM Sunday-AM

Availability Afternoons

Monday-PM Tuesday-PM Wednesday-PM Thursday-PM Friday-PM Saturday-PM Sunday-PM

Language Skills

Language-1

LanguageA1

Write Fluently Speak Fluently

Language-2

LanguageA2

Write Fluently Speak Fluently

Areas of Interest (one or more)

Interests

Disaster Services (casework, logistics, assessment)
Youth Programs(Red Cross School Clubs)
Community Education(disaster preparedness)
Health and Safety Instruction(First Aid/CPR/AED)
Disaster Action Team(on-call fire response team)
Service to the Armed Forces(emergency messaging service)
Office-Front Desk Support
Fundraising(special events, Club 200, Walkathon)

Other Interests:

Background Information:

Occupation:

Education:

High School College Graduate School

Currently Employed?

No Yes

Position-Title:

Employer:

Have you ever volunteered?

No Yes

Name of Organization:

Volunteer Jobs Performed

Have you volunteered with the American Red Cross previously?

No
Yes

What Chapter?

How did you hear about the volunteer opportunities at the American Red Cross?

How did you hear?

Community Event
Friend-Relative
Internet
Newspaper
Volunteer Agency
Our Website
Other

Why do you want to volunteer?

To Serve School Credit Court Ordered

Other Reason:

Briefly, why do you choose to volunteer for the American Red Cross?

Why Volunteer?

Emergency Contact Information

Name

Relationship

Conact Phone-Cell:

References. (include name, relationship and phone number)

Reference list

Volunteer Agreement

I agree that the information on this application is true and correct to the best of my knowledge. I authorize entities named in this application to provide any relevant information that may be required regarding my volunteer placement.

agreement

I agree I disagree