Volunteer Application "*" indicates required fields Step 1 of 5 20% You must agree to the below Confidentiality Policy and the Release for Criminal History, Background & Reference Checks to become a volunteer for WISE.Confidentiality Policy*I recognize and understand the confidential nature of information about persons who receive services through the Women’s Information Service, Inc. I realize the names and information about these persons are protected by the State of Michigan. As a member of Women’s Information Service, Inc. through my status as staff, volunteer or intern, I understand that I occupy a position of trust. I agree not to divulge information contained in records or heard while I am in the shelter or other organizational offices. I will abide by these confidentiality constraints both while regularly employed or involved with the Women’s Information Service, Inc. and after I end my employment or involvement. I agreeRelease for Criminal History, Background & Reference Checks*I authorize WISE (Women’s Information Service, Inc.) to perform criminal history and background checks and a check of my personal references. I agree Contact & Background InformationName* First Middle Last Have you ever gone by any other names? (i.e. maiden name)* Yes No Please explain and give previous name(s):*Birthdate* Gender* Male Female Address* Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code What county do you live in?*When is the best time to contact you?* Morning Afternoon Evening PhoneEmail Race*Please chooseWhiteBlackAsian or Pacific IslanderAmerican Indian or Alaskan NativeOtherHispanic? Yes No EmployerOccupationHighest Education Level Emergency ContactName First Last Address Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code PhoneRelationship to you How did you learn about WISE?Please provide an outline of your availability. Example: ‘Available 10 a.m. to 4 p.m. Monday through Thursday. Not available on Fridays or for overnight work.Have you ever been convicted of a felony or a misdemeanor?* Yes No Please explain.*Do you have a certain number of hours of volunteering to be completed by a specific date? Yes No Hours NeededNeeded By Name of the organization requiring the timeIf you are willing to transport, please check all that apply to you. Own/Have Access to Car Own/Have Access to Truck Willing to Make Deliveries Willing to Transport Clients Have a Driver’s License Have Auto Insurance Driver's License NumberState Issued ByAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificAuto Make & ModelLicense Plate Number Skills, Interests & ExperienceAreas of volunteering interest(check all that apply) Administrative Advocate Support Children’s Program Crisis Line Crisis Response Maintenance Publicity Shelter Transportation Other / Not sure Skills and experience(check all that apply) Carpentry Childcare Cleaning Computer Crafts Crisis Hotline Crisis Response Events Foreign Language Hair Stylist Life Skills Maintenance Mentoring Musician Office Organizing Painting Publicity Sewing Sports Transportation – People Transportation – Supplies Videography Other Other skills and experienceDescribe any special talents or skills you possess.List any work or school experience that you feel would make you a good volunteer.Briefly discuss why you would like to become a volunteer with our program.