Volunteer Application
Title: Dr. Mr. Miss Mrs. Ms.
First: ____________________ MI: ______ Last: ___________________________ Suffix: _______
Address: __________________________________________________________________________
City: _____________________________________ State: ______ Zip: ____________________
Phone (Home): ( ___ )_______-__________ (Mobile): ( ___ )_______-__________ (Work): ( ___ )_______-__________
Email: ______________________________________________ Birthdate: _____/_____/_____
Reason for Volunteering: Internship Event Volunteer Court-Ordered School Other
What is your preferred store location?
Canton Livonia Commerce Woodhaven Dearborn Ypsilanti
AVAILABILITY:
How many hours are you available for? ________ I am flexible to work any shift ______
(Please initial)
What time of the week is best? M T W Th F Sat Sun Time(s): _______
a.m. OR p.m.
_______
a.m. OR p.m.
# of hours needed (if community service): ______________ Date the hours need to be completed by: ______________________
EMPLOYMENT: Current Retired Unemployed
Company Name: ____________________________________ City, State: __________________________, _______
Contact: ___________________________________________ Phone #: ( ___ )_______-__________
EDUCATION:
High School/GED No Yes (School Name: ______________________ City: _____________________)
Trade School/Community College No Yes (School Name: ______________________ City: ____________________)
Bachelors Degree: No Yes (School Name: ______________________ City: _____________________)
Masters Degree: No Yes (School Name: ______________________ City: _____________________)
Area of Study: ___________________________ Club or Organization: ____________________________________________
How did you hear about us?
Newspaper TV Radio School/College Friend/Relative Other:
Why are you interested in volunteering for Goodwill?_____________________________________________________________
___________________________________________________________________________________________________________
INTEREST: What kind of volunteer work are you interested in?
Accounting Assisting adults with Disabilities Clerical/Administrative
Retail Store Help Data Entry Internet/Web Research
Customer Service Phone Calls Mentoring
Other ___________________________________________________
Inter-office use only:
RE # ______________
E □ S □ FM □
Volunteer Application
SKILLS or HOBBIES: Summarize special skills and qualifications from previous experiences.
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
PREVIOUS VOLUNTEER EXPERIENCE: Summarize your previous volunteer experiences.
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
TRANSPORTATION: Car Bus Walk Other
Do you require special accommodations? No Yes
Are there any groups with whom you would not feel comfortable working with? No Yes (If so, please explain below)
___________________________________________________________________________________________________________
BACKGROUND CHECK: Do you have a criminal record? No Yes (If so, please explain below)
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
REFERENCES: (Personal or Professional)
Name Address, City, State, Zip Phone
# 1 ____________________________________________________________________________________________________
# 2 ____________________________________________________________________________________________________
# 3 ____________________________________________________________________________________________________
EMERGENCY CONTACT:
Name (first & last): ____________________________________________________________________________
Address: ___________________________________________________________________________________
City: ______________________________________________ State: ________ Zip: ______________________
Phone #: ( ___ )_______-__________ Email: ___________________________________________________
I certify that the information contained in this application is correct and complete to the best of my knowledge. I realize that misrepresentation of facts will be cause for
rejection of this application. I understand that my enrollment as a volunteer is contingent upon successful completion of the application process, including reference
checks and a criminal history check. I give my permission for my references to release information about me and my criminal history verified. I understand that
Goodwill Industries of Greater Detroit does not discriminate on the basis of race, color, national origin, sex, disability, age or religion and that this application will be
handled in a confidential manner.
_____________________________________________________________ ________________________
Signature Date
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signature
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GOODWILL INDUSTRIES OF GREATER DETROIT
Criminal History Background Check Consent Form
As a prospective volunteer being considered for placement, I
___________________________________, understand that it is Goodwill Industries of
Greater Detroit policy to secure a criminal history background check as part of my volunteer
screening process using the information provided below.
Name ___________________________________________________________________
Last First Middle
Maiden name or names previously used: _______________________________
________________________________________________________________
Birthdate _____ /______ /______ Race __________________ Sex _____
I understand that the above information is required by the Central Records Division of the
Michigan State Police, Lansing, Michigan. I authorize Goodwill Industries of Greater Detroit
to utilize the above information for the sole purpose of obtaining a criminal history file
search.
___________________________________ ______________________________
Signature of Applicant Date
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signature
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