VOLUNTEER APPLICATION CONFIDENTIAL

Date

Send Completed Application To: Michael E. McDonnell Director of Volunteer Relations Catholic Charities 721 N. LaSalle Street MC#111-2N Chicago, Illinois 60654
First City State Middle Zip Code Date of Birth Telephone Number (Day) Telephone Number (Evening)

Name - Last Address Email Address

Names of Schools and Mailing Addresses College

Date Started

Date Ended

Degree

Major

E D U C A T I O N A L H I S T O R Y

High School

Did You Graduate? Yes No

Trade School Yes No Are you a veteran? if so, which branch?

Special Certification Are you licensed or certified? Yes No Date of Expiration:

Type of License or Certification License or Certification No.

FOREIGN LANGUAGE(S):

Please list the foreign langauges(s) in which your knowledge is adequate for everday usage. Indicate whether you (S), (R) read, or (W) write the language.

Special training or qualification in your occupational field, including Memberships and Professional Organizations (please expalin):

Company Name Address

EMPLOYMENT

Telephone

NO

Can you be contacted at work? YES

Job Title and Description

Volunteer Work Preferred: Please note times that you are available to volunteer for a given day.

Direct Service
Seniors Meals on Wheels Children Homeless Veterans Senior Centers Refugees Transportation Tutoring Legal Mentoring Health Food Pantry Clothing Room Other:

Monday

Tuesday

Wednesday Thursday

Friday

Saturday

Sunday

Support Service
Mailings/ Office Support Computer Work Special Events/ Projects Fundraising Other:

Monday

Tuesday

Wednesday Thursday

Friday

Saturday

Sunday

Locations where you would like to do volunteer work:

City of Chicago: Suburban Cook County: Lake County: ____ North ____ Near North ____ West ____ West Loop ____ South ____ West ____ Southwest

____ North/Northwest ____ Lake County

EMERGENCY INFORMATION
Person to contact in case of emergency: Telephone

Address

How are they related to you?

REFERENCES
Please list three people that we may contact for references. Relatives may not be used. At least one of your references must be an employer (past or present) or professional person. Please list name, address, city, state and zip code as we contact your references by standard mail. I grant permision to Catholic Charities to contact the mentioned references

Signature

Date

Regular, ongoing volunteers are required to submit to a criminal background check. Will you grant Catholic Charities permission to conduct a criminal background check on you? ___ Yes ___ No Have you had a felony conviction which has not been annulled, expunged or sealed by a court? ___ Yes ___ No If yes, please explain: