Volunteer Application Form Home > Learn About Volunteering > Volunteer Application Form A A A Submit form for individual volunteering or group participation. This application is on behalf of: * RequiredAn individual or familyA corporation or group like ScoutsCONTACT INFORMATION: INDIVIDUALName First Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail CONTACT INFO: GROUPS OR CORPORATIONSName of Group or OrganizationAddress Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail FOR INDIVIDUALSDo you have any volunteer experience? * RequiredYesNoIf yes, please explain:TransportationDo you have reliable transportation?YesNoDo you have a valid driver’s license?YesNoBackground ChecksHave you ever been convicted of a crime?YesNoIf yes, state what type of crime, the court and date of conviction and present status.Do you have a conviction or prior history of child abuse, neglect or mistreatment?YesNoWhat special interests or hobbies can you share (e.g., fishing, quilting, music, arts, etc.)?Describe any experience you may have with people who have developmental disabilities.Please list three references and their contact information.Reference NamePhone NumberEmail AddressAdd or remove row Use + sign to add information for multiple references.PREFERENCESFOR CORPORATIONS/GROUPS: Have you ever volunteered for Heritage Christian? * RequiredYesNoIf yes, please explain:I/we want to volunteer in areas closer to: * RequiredRochesterBuffaloAreas of Interest (check all that apply): Residential - forming relationships with adults who live in agency homes and are typically available evenings and weekends Day programs - working in the community alongside adults who are a part of agency day programs and are typically available weekdays Respite - spending time with children and adults who enjoy our short-term care services and homes Special events - community events that promote the good work and goodwill of Heritage Christian Services International Ministries – wheelchair collections plus home builds and serving at retreat centers in Central America A Second Thought Resale Shop –thrift store in E. Rochester only Springdale Farm –public demonstration farm in Ogden only Heritage Christian Stables –therapeutic riding program in Webster only Bakeries in Spencerport or Webster Pieters Family Life Center – community health and wellness center in Henrietta only Club Adventure - respite program in Tonawanda only Community garden in N. Tonawanda only List dates and timeframes that you wish to volunteer:Number of people we can expect (age 18 or over):Number of youths (under age 18):Names of Youth we can expect (under age 18): Use + sign to add names to list.Are allergies a concern?YesNoIf yes, please explain:ADDITIONAL INFORMATIONWhat led you to choose Heritage Christian Services?Would you like information about joining the Heritage Christian Young Professionals?YesNoWould you be interested in sponsoring Heritage Christian Services, especially events that include perks, like at the Golf Classic and Heritage Hero 5K + Mile Stroll & Roll?YesNoBy submitting this form I certify that I am the primary contact and that all information is correct.