Employment/Volunteers

Positions/Internships/
Volunteers

Volunteer Application

 

24-Hour
Suicide Crisis Line
916-368-3111

Also 800-273-8255

24-Hour
Parent Support Line
888-281-3000


Locations

Volunteer Application

IMPORTANT: Thank you for your interest in becoming a volunteer! Please complete the entire application form below. If The Effort has volunteer openings available in your area of interest, you will be contacted for phone screening.
Please no phone calls regarding these volunteer openings.


Name:
Are you 18 years of age or older:
Address:
City, State, ZIP:
Home Phone:
Work Phone:
Email Address:
Best day(s) and time(s) to contact you:
EDUCATION
Highest Grade Level Completed:




Degree Attained:
Degree Attained From:
Are you presently enrolled as a student:



Name of School:
Degree you will receive and date:
EMPLOYMENT HISTORY
Are you presently employed:

Current Employer:
Position:
Phone:
Length of Employment:

Past Employer:
Position:
Phone:
Length of Employment:
VOLUNTEER EXPERIENCE AND TRAINING
(If you have volunteered at another organization)

Organization #1:
When:
How Long:
Your Duties:

Organization #2:
When:
How Long:
Your Duties:

Organization #3:
When:
How Long:
Your Duties:
BUSINESS REFERENCES
(Please provide complete addresses for all references listed)

Reference #1 Name:
Phone:
Work Relationship:
Address:
City, State, ZIP:

Reference #2 Name:
Phone:
Work Relationship:
Address:
City, State, ZIP:

References #3 Name:
Phone:
Work Relationship:
Address:
City, State, ZIP:
BACKGROUND INFORMATION
(Please answer the questions below as completely as possible.)
Have you ever been convicted of a felony:
 
If yes, please describe:
If you volunteering for a provider position, have you ever been refused malpractice insurance:
 
If yes, please describe:
GENERAL QUESTIONS
How did you hear about our volunteer program:
 
Are you related to or have a personal relationship with anyone currently working at WellSpace Health:
 
What interests you in volunteering with WellSpace Health:
 
What languages do you speak fluently:
 
Crisis Line Volunteers Only: Is there a personal reasons for becoming involved in crisis work:
 
VOLUNTEER INTEREST
Please select the volunteer opportunities in which you may be interested:
 
Crisis Line Volunteer
Community Service Volunteer
Accounting Intern Volunteer
Computer Intern Volunteer
Counseling Intern Volunteer
Clerical Intern Volunteer
Women's Health Volunteer
CERTIFICATION OF APPLICANT
Some volunteers may be required to have his/her own transportation and vehicle insurance. All volunteer candidates are subject to illegal drug testing, TB testing and criminal background screening. Provider volunteers are subject to credentialing.
Volunteer positions are completely unpaid and volunteers are not entitled to any type of benefits with WellSpace Health, Inc.
By submitting this form, you certify that youur answers on this application are true and complete to the best of your knowledge. You also grant your permission and consent for WellSpace Health, Inc. to contact the necessary resources and references to verify your responses on this application.