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Volunteer Application
Step
1
of
4
25%
You must agree to the below statement to become a volunteer for WISE
*Starred fields must be completed for the purpose of a criminal background check.
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 also give permission for the Women’s Information Service, Inc. to perform a criminal history check and a check of my personal references.
I am authorizing WISE (Women's Information Service, Inc.) to perform criminal history and background checks and a check of personal references, required by this agency.
*
I agree
Name
*
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
*
MM slash DD slash YYYY
Gender
*
Male
Female
Address
*
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
What county do you live in?
*
When is the best time to contact you?
*
Morning
Noon
Evening
Phone
Email
Race
*
Please choose
White
Black
Asian or Pacific Islander
American Indian or Alaskan Native
Other
Hispanic?
(optional)
Yes
No
Employer
Occupation
Highest Education Level
Emergency Contact
Name
First
Last
Address
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Phone
Relationship 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
Please specify hours needed
Date to be completed by
MM slash DD slash YYYY
Name of the organization requiring the time
If 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 number
State licence issued from
Auto make and model
License Plate Number
Skills and interest/experience
Areas of volunteering interest
(check all that apply)
Administrative
Advocate Support
Children's Program
Crisis Line
Crisis Response
Fabulous Finds Resale Store
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 experience
Describe 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.