Volunteering

Bridgebuilders Volunteer Application

Date:
Last Name:	First Name:
Address:	Phone #:
Town:	Zip:
e-Mail Address:	Birthdate:
Occupation:	Employer:
Emergency Contact:	Phone #:
Work and/or other relevant experience (including volunteer experience):
Education or training that relates to the volunteer position sought:
Interests, skills or hobbies:
Are you fluent in other languages besides English? (specify):
How did you hear about our volunteer program?:
On Premise of Kip Center Kitchen Thrift Classes Office Fund Raising Entertainment Other
Home Friends
Availability: Which days of the week? Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Do you prefer morning, afternoon, or evening?
Are you willing to fill in for another volunteer in case of an emergency? Yes     No
Would you be able to provide transportation for a client to a doctor's appointment, food shopping or other essential transportation needs? Yes      No
If you said yes to the above, please comlete the following information:
Car Insurance: (This information is required for all applicants transporting clients)
Name of Insurance Company:
Policy Number:
NJ Drivers License Number:
Please give two references: Please do not list relatives
Name: Relationship: Address: Phone: Town & Zip Code: Name: Relationship: Address: Phone: Town & Zip Code: