Anna Marie's Alliance
Volunteer Application
Please print out the application, complete it, and send to the
Volunteer Coordinator. We look forward to hearing from you!
(Click on the BACK button of your browser to return to the web site)
Print and mail application to:
Volunteer Services
P.O. Box 367
St. Cloud, MN 56302
Or Fax us at (320) 253-5563
OFFICE USE ONLY
RCVD _______ INT ________
RCHK _______ INVT _______
CCHK _______
TRN _________ CMPLT ______
STRT ________ END ________
Personal Data
Full Name _______________________________________________
Current Mailing Address _____________________________________
City _______________________ State _______ Zip Code _______
Home Phone ________________ Work Phone _________________
Current employer/workplace:__________________________
Preferred email address: ____________________________________
Specific Volunteer Positions you are applying for:
____ Auction Team [Development Office]
____ Bulk Mail preparation [Marketing - Business Office location]
____ Child Care/Child Mentor [Anna Marie’s shelter]
____ Court Monitor (weekdays) [Criminal Justice Intervention Program]
____ Transport clients (weekdays) [Anna Marie’s shelter]
____ Hospitality at Anna Marie’s public events [Development Office]
____ Grocery shopping transport provider for Transitional House [Mondays at 6 p.m.]
____ It Counts marketing staff [Development Office]
____ Interpreter: Language _____________ [Anna Marie’s shelter]
____ Meal preparation (1 weekend meal/month)
____ Women's Advocate [Anna Marie’s shelter]
Is your volunteer time a requirement for a class, church, community service, etc? Yes ____ No _____
If so, what is the volunteering for? _________________________
Instructor’s Name: ___________________ School _______________________
How many hours are required? ________ Required completion date _________
Is an evaluation of your work required? _______ Date/s required _____________
How many hours/month are you committing to? _____
Educational Background including degrees earned
____________________________________________________________________ ____________________________________________________________________
____________________________________________________________________
Please place a checkmark on the area below that applies.
Have you professionally worked with people who have experienced:
____mental illness or ____ chemical dependency?
Please describe the extent of your experience:
If applying for direct service positions such as for Women’s Advocacy, are you willing to participate in training on these issues? ____ Yes ___ Not right now
___ No
Employment Background
_________________________________________Phone______________________
_________________________________________Phone______________________
_________________________________________Phone______________________
May we call your former employers for references? ____ Yes ____ No
Community volunteer experience
Place:_______________________________How did you help?_________________
____________________________________________________________________ Place:_______________________________How did you help?__________________
____________________________________________________________________
Special Skills, Interests, Abilities:
Do you speak or read a second language other than English? _____
If so, specify: _____________________
Would you be willing to translate for residents when necessary? ______
Other skills: ____________________________________________________________________
____________________________________________________________________
Do you have a valid driver's license? ______
Have you had any traffic violations in the past three years? _____
If yes, please specify: ___________________________________
Have you been arrested or convicted of any felony? ____
If yes, please explain: ______________________________________
_________________________________________________________________
Have you been arrested or convicted for any violations of the law? ______
If yes, please specify: ________________________________________________
References: Please include at least one work reference.
Do not include family members or room mates.
Supply daytime phone numbers whenever possible.
Name: _________________________ Phone: ______________________
Address/City/State/Zip: _________________________________________________
How do you know this person? _________________________
How long have you known him/her? ________________
Name: _________________________ Phone: ______________________
Address/City/State/Zip: _________________________________________________
How do you know this person? _________________________
How long have you known him/her? ________________
Name: _________________________ Phone: ______________________
Address/City/State/Zip: _________________________________________________How do you know this person? _________________________
How long have you known him/her? ________________
I authorize Anna Marie’s Alliance to contact the above references. I certify that the above information is true and verifiable to the best of my knowledge. I also understand that all information contained within this application will remain confidential. I understand that as part of the screening process for my application to volunteer, I will be required to complete and submit a criminal history background check.
Signature ____________________________ Date ________________
General Information Questionaire
Please list any previous training or experience you have in Human Services and/or Crisis/Support services.
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Without compromising your privacy, briefly explain your interest in volunteering for Anna Marie’s Alliance.
____________________________________________________________________ ____________________________________________________________________
____________________________________________________________________
Discuss the problem of Domestic Abuse as you understand it, i.e. why battering exists, why women stay, etc.
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Discuss your understanding of issues which arise for children living in families where wife battering/ domestic abuse exists.
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
What do you perceive will be the most difficult aspect of this volunteer work?
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Please list specific days, evenings, and times you are available to volunteer.
____________________________________________________________________
____________________________________________________________________
When is the best time to call you? ___anytime ___weekday ____evening