Volunteer Profile

 

Name     Mr.   Ms.   Miss.   Dr.   Rev.                                                                  Nick Name                                     

Address (Street, City & Zip)                                                                                                                                           

Business Address                                                                                                                                                        

Telephone    (H)                                                  (W)                                            Cell/Pager                                                   

E-Mail Address                                                                                    Fax                                                                 

Emergency Contact Name                                                                        Relationship                                        

Emergency Contact Phone                                                                   

Your Place of Employment                                                                    Occupation                                                     

School (if student)                                                                                 Full Time                        Part Time                  

 

Please list other experiences that you think might relate to Red Cross volunteering (work, school or other volunteering)

 

 

 

How did you hear about becoming a Red Cross volunteer?                                                                                          

 

Reason for wanting to be a Red Cross volunteer?                                                                                                         

 

Please list skills, hobbies or interests that might be helpful in your work as a Red Cross volunteer                       

                                                                                                                                                                                   

 

Do you fluently speak a foreign language?                        Which?                                                                                  

 

Specific skills you would like to share:  

record keeping            receptionist                 typing              bulk mailings               computer

teaching          maintenance/repair                 nursing            driving             casework           fundraising

 

 

Are you a licensed RN_____      LPN_____    EMT_____    Ham Radio Operator_____    Other                               

 

Have you ever been a Red Cross volunteer or employee?   If yes, give position, number of years, and location:

 

                                                                                                                                                                                   

 

If you will be driving a Red Cross Vehicle, please fill out the following information:

 

Current Driver’s License #                                                               State ________    Expiration date             

 

Please list two references who have knowledge of your qualifications (Do not include relatives):

 

Name

Relationship

Address

Phone

 

 

 

 

 

 

 

 

 

 

Times you are available:

 

Monday           Tuesday           Wednesday        Thursday          Friday               Weekends                            

am   pm            am    pm           am      pm          am     pm          am   pm             Nights                                  

 

Number of hours you would like to work:          Week                                       Month                        

 

Months which you are NOT available:

JAN       FEB      MAR        APR       MAY       JUN      JUL       AUG        SEP       OCT          NOV       DEC

 

 

The following information is needed to determine the diversity of our volunteers; completion is optional:

 

Date of Birth                                                                 Sex:         Male                               Female                  

 

Disability or Physical Limitations?           If Yes, please specify                                                                                      

 

Racial Demographics:

White ____      Black ____      Hispanic ____     Native American ____     Asian ____    Pacific Islander _____         

 

Employed_____           Unemployed_____           Retired_____           Student_____               Homemaker_____

 

 

 

Mail this Volunteer Profile to:

American Red Cross, Volunteer Services, 313 W. Webster Avenue, Muskegon, MI 49440