Catholic Community Services of Utah - Volunteer Application

Volunteer Application

	If you would like to volunteer with Catholic Community Services of Utah, please complete this volunteer application. Please review the "Volunteer Opportunities" page to select below your area of interest.
First Name (*)	Invalid Input
Last Name (*)	Invalid Input
Organization (if any)	Invalid Input
Street Address (*)	Invalid Input
City (*)	Invalid Input
State (*)	Invalid Input
Zip Code (*)	Invalid Input
Cell Phone (or best phone #) (*)	Invalid Input
Home Phone	Invalid Input
Work Phone	Invalid Input
Email Address (*)	Invalid Input
	EMERGENCY CONTACT
Emergency Contact (*)	Invalid Input
Relationship to you (*)	Invalid Input
Emergency Contact Number (*)	Invalid Input
	WORK EXPERIENCE
Current Employer	Invalid Input
Current Position	Invalid Input
Previous Employer	Invalid Input
Previous Position	Invalid Input
	REFERENCES Please list three people who are able to complete a reference referral on your behalf. Your application cannot be processed until these referrals are returned to us.
Reference 1 (*)	Invalid Input
Reference 1 Phone (*)	Invalid Input
Reference 2 (*)	Invalid Input
Reference 2 Phone (*)	Invalid Input
Reference 3	Invalid Input
Reference 3 Phone	Invalid Input
	EDUCATION
Indicate levels of education completed (*)	High School Some College Bachelor Degree Graduate Degree Invalid Input
Field(s) of Study	Invalid Input
	LANGUAGES CCS serves clients who speak many languages, indicate any foreign languages you can speak, read and/or write
Language	Invalid Input
Indicate fluency level	Fluent speaking Fluent reading Fluent writing Good speaking Good reading Good writing Fair speaking Fair reading Fair writing Invalid Input
Language	Invalid Input
Indicate fluency level	Fluent speaking Fluent reading Fluent writing Good speaking Good reading Good writing Fair speaking Fair reading Fair writing Invalid Input
	SPECIAL SKILLS/PROFESSION Do you possess any special skills or do you work a profession that requires knowledge that may be useful during your time as a volunteer at CCS?
Describe your skills	Invalid Input
	TRANSPORTATION Information regarding drivers license number and insurance information may be required later, if applicable.
Do you have access to a vehicle? (*)	Yes No Invalid Input
	VOLUNTEER EXPERIENCE Please describe current or past volunteer experience. Include the name of the agency and your duties.
Describe your experience	Invalid Input
	VOLUNTEER AVAILABILITY
I am interested in volunteering as (*)	Individual Family/Friend Group Corporate Group Invalid Input
If a group, what is your group size?	Invalid Input
List your group's organization or business	Invalid Input
Age range of you and/or your group (*)	12-15 16-18 19-60 60+ Invalid Input
How long do you see yourself volunteering with CCS? (*)	One time Short term - 4 months Medium term - 4-9 months Long term - 9 months or more Invalid Input
Your availability (*)	Monday Tuesday Wednesday Thursday Friday Saturday Sunday Mornings Afternoons Evenings Invalid Input
	VOLUNTEER INTEREST Please review the "Volunteer Opportunities" page to select below your area of interest.
Where would you like to help? (*)	Refugee Resettlement: Job Development Refugee Resettlement: Mentor Refugee Resettlement: Teach English Refugee Resettlement: Tutor Refugee Resettlement: Home Set-Up Treatment Services: Teach Classes Basic Needs Services (SLC): Serve Lunch Basic Needs Services (SLC): Assist in Pantry Basic Needs Services (Northern Utah): Assist in Food Bank Basic Needs Services (Northern Utah): Client Intake Basic Needs Services (Northern Utah): Food Box Deliver Basic Needs Services (Northern Utah): St. Martha's Baby Project Administrative Maintenance Invalid Input
How did you hear about volunteering with CCS? (*)	Invalid Input
	JOIN OUR LIST
May we add you to our list to receive updates from CCS? (*)	Yes No Invalid Input
	CCS VOLUNTEER AGREEMENT I agree to maintain the same strict confidentiality regarding my duties at Catholic Community Services as that expected of paid staff. I understand that while working as a volunteer, I am not considered an employee of Catholic Community Services. I have reviewed this application completely and certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application.
	By typing my name on the form, I acknowledge that I have signed this document and will adhere to the agreement above and understand that my typed name is equivalent to my signature.
Volunteer Signature (*)	Invalid Input

	DOCUMENTS & FORMS The following forms are unneccessary unless instructed by the Volunteer Coordinator for a specific volunteer postion. Please print the applicable form and mail to 745 E 300 S, Salt Lake City, UT 84102, Attn: Volunteer Coordinator. Thanks for volunteering! A. Volunteer Package & Personnel Forms B. Volunteer Code of Conduct (Form C) C. Department of Workforce Services Disclosure of Confidential Information (Form D) D. Diocese of Salt Lake City - Disclosure & Information Form E. How to Access the Safe Environment for Children F. Utah Department of Human Services Background Screening Application

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Mission of Catholic Community Services: To practice gospel values of love, compassion and hope through service, support and collaboration.
Catholic Community Services of Utah serves people in need regardless of race, religion, disability or ethnicity.
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