Hope Haven Volunteer Online Application

† Required Fields

Personal Information

First Name †

Last Name †

Middle Name

maiden / other name

email address

social security number †

Date of birth

driver's license number †

home phone number †

cell phone number

Current Address

City

state

ZIP

how long at current address?

how long have you lived in texas?

Previous address if you have moved in the last 5 years

city

state

zip

Current Church Membership

military serviceYesNo

which branch of service?

are you currently employed?YesNo

part time?full timepart time

if yes, where?

what is your role in your current job?

highest level of education

Employment History

Employer One

Employer

Dates

position

skills & experience

Employer Two

Employer

Dates

position

skills & experience

Vounteer Experience

what do you feel are your special skills, talents, or hobbies?

please list the agencies or areas where you have served as a volunteer.

why would you like to volunteer for Hope Haven?

Background Check

Have you ever been convicted? †YesNo

If yes, please state reason and charges:

Date of charge

TEXAS LAW PERMITS OBTAINING RECORD OF CONVICTIONS, DEFERRED ADJUDICATIONS OF FELONY CHARGES AND CURRENT OFFENSES. I UNDERSTAND A CRIMINAL HISTORY CHECK MAY BE DONE. †I understand

initial †

Non-Family Member References

Reference One

Reference Name

phone number

Relationship/title

yrs. known

address

city

state

zip

Reference Two

Reference Name

Phone Number

relationship/title

yrs. known

address

city

state

zip

Emergency Contact Information

Contact One

Name

relationship

phone

Contact Two

name

relationship

phone

How did you hear about Hope Have Volunteer Program

NewspaperHope Haven StaffVolunteerOther

other

Agreement

By signing below, I certify this information is true and correct to the best of my knowledge and I understand that any misrepresentation or willful omission of facts will be cause for rejection of this application or termination of my volunteer association. I hereby authorize Hope Haven, to conduct personal reference checks, driving history and/or criminal conviction records to determine my acceptability for a volunteer position. I further agree to observe all rules, regulations and policies of Hope Haven.

signature

date

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Volunteer Application

Volunteer Application

Hope Haven Volunteer Online Application

† Required Fields

Hope Haven of East Texas

430-235-2032