| Name |
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| Address |
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| City |
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| State |
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| Zip |
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| Home Phone |
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| Work Phone |
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| E-mail |
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| Fax |
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| Birthdate |
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| Employer |
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| Address |
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| Brief Employment History |
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| May We Contact You at Work? |
 Yes
No
If so, what is the best time?
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| Have You Ever Been Arrested? |
Yes
No
If yes, were you convicted?
Yes
No |
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| How did you hear about a Wish with Wings? |
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| Why would you like to become involved with a Wish with Wings? |
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| Other Volunteer Work |
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| Other Community Involvement and Offices Held: |
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| Please list any Special Skills or Hobbies: |
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| Time You Can Volunteer: |
Weekly
Monthly
Best Day(s)
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| Type of Volunteer Work You Are Interested In |
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| Would You Be Interested In Heading a Committee? |
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Yes
No |
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| Would You Be Interested In Being on the Board of Directors? |
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Yes
No
Perhaps |
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| Do You Have Any Ideas for Fund Raisers or Ways to Keep the
Volunteers Involved? |
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| Please list the names, addresses and day phone numbers
of two people who have known you for at least two years. |
Name:
Address:
Address 2:
Phone:
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Name:
Address:
Address 2:
Phone:
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I certify that the information contained in this volunteer application is correct to the best of my knowledge. Further,
I consent to my current and previous employers, and other people given as references, responding to the verbal or written
request for further information. I understand that in my association with a Wish with Wings, Inc., I may from
time-to-time learn of or be exposed to certain sensitive or confidential information, including but not limited to:
identities of prospective Wish participants, their illnesses, background information, as well as identities of
sponsors or donors, and other budgetary and administrative information about
and/or its programs. To avoid embarrassment to and foster the orderly administration of
and its programs, I agree not to disclose any information learned by me in my association with
to the media or anyone else, except for my general impressions of
concept and program, and I agree to refer any inquiries about
its programs, participants, sponsors, or donors to the Executive Director or its Board of Directors for an appropriate
response.
I understand that because a Wish with
Wings endeavors to keep each child's Wish a very special and magical
experience, there is seldom an opportunity for direct contact with Wish
children or their families. My services as a volunteer will be primarily
utilized to help raise the funds necessary to grant these Wishes.
I hereby certify that clicking the below Submit button signifies my signature to the above statement.
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