RCD. _____/_____/_____ CHF. _____________ Desired Location / Check One: West/CA Midwest/IL Southwest/TX (for CHF office use only) VOLUNTEER SPECIALIST APPLICATION Applicant Information ___________________________ _____________________________________ ________ Name (First) (Last) (M.I.) _________________________________________________________________________ Current Mailing Address _____________________________________________ __________ _________________ City State Zip _________________________________________________________________________ Permanent Address (if different from above) _____________________________________________ __________ _________________ City State Zip (_______)_________-________________ Phone (_______)_________-________________ (Home) _________________________________________________________________________ E-mail Home Phone How did you hear about volunteering at CHF? Volunteered for CHF before A friend Languages you read fluently: English Spanish Other __________________________ Languages you write fluently: English Spanish Other __________________________ Your usual availability, between 8am/4pm: Day From To Monday (Cell) How do you prefer to be contacted: Languages you speak fluently: English Spanish Other __________________________ Cell Phone Email CHF web site CHF employee CHF event Other (describe): Tuesday Wednesday Thursday Friday Saturday Availability for Volunteer Specialist Assignments/Projects What date could you start?_______________________ Through what date would you be available?________________________ If CHF has irregular volunteer opportunities (such as for a day or week or special projects at various times during the year), how much advance notice would you need in order to see if you would be available? 1 day 2 days 1 week Other (describe):___________________________________________________________ Education / Employment Highest level of education (if college, what school/degree): ____________________________________________________________ Currently employed? Yes, name/address of employer, position, hire date ______________________________________________ ___________________________________________________________________________________________________________ No, last date of employment, reason for leaving __________________________________________________________________ Skills / Experience What skills/experience do you have (check all that apply) : Filing Mailings Receptionist/phones Computer user: Copier Fax Beginner Intermediate Advanced Scanning Construction Maintenance Other skills that may contribute to CHF’s ministry, including any prior volunteer experience (describe): Children's Hunger Fund Effective: 05/09/2013 Volunteer Specialist Application Page 1 of 2 Christian Testimony / Church Information As a Christian 501(c)(3) non-profit religious organization, the gospel is at the heart of all we do at CHF. Please give a brief description of how you came to faith in Christ including how long you have been a Christian. (use a separate sheet if desired) Do you attend a local church? Yes, how long _________; No Are you a member? Yes No Church Name, City/State: _____________________________________________________________________________________ What is your level of involvement at your church? (check any that apply) attend worship service attend a small group participant in outreach/ministry leader (of an activity/small group) Reference Form If an interview is requested by CHF, one reference will be required in advance, preferably from your pastor or a non-family adult (other than a CHF employee) who knows your Christian character. CHF will provide you with the form to give to your reference; instructions for its return are included on the form. If offered a Volunteer Specialist assignment or project, a signed confidentiality agreement and hold harmless waiver will also be required. Acknowledgments Are you age 18 or older? Yes Do you currently use illegal drugs? No Yes Do you have reliable transportation to and from CHF? Yes No No CHF does not permit volunteers to come to CHF facilities while under the influence of alcohol or illegal drugs or to use alcoholic beverages or illegal drugs while wearing or carrying CHF-logo items. Can you comply with this policy? Yes No For health and safety considerations, CHF discourages smoking. No smoking is permitted on Children’s Hunger Fund property. Can you comply with this policy? Yes No Have you ever been convicted of, or are you awaiting trial for, a felony, or a misdemeanor for which the record has not been sealed or expunged? (exclude misdemeanor convictions for marijuana-related offenses that are more than two years old) Yes No If Yes: please briefly describe the nature of the crime, the date and place of conviction, and the legal disposition of the c ase. Read carefully and initial each statement with which you agree: ______I authorize the investigation of all statements and information contained in this application. I release CHF and anyone contacted in the course of verifying the information I have supplied from all liability and damages that may result from any information they provide. I understand that falsification of any information on this application will disqualify me from consideration. ______I understand that CHF is a Christian 501(c)(3) non-profit religious organization and all volunteer service is on an unpaid basis. ______I understand that either CHF or I may end a Volunteer Specialist assignment at any time, for any reason, with or without notice. ______Recognizing that CHF provides product and services to churches of various theological persuasions, distinctions, worship styles, ministry styles and traditional backgrounds, Volunteer Specialists will refrain from the promotion of theological persuasions, distinctions, etc. of their church or denomination to avoid controversy on such issues, and focus on the great common ground we all hold as believers in Christ. By my signature below, I acknowledge that I have read, understand and agree with all information on this Application. ______________________________________________________ Applicant’s Signature ______________________________ Date Application may be faxed to 818-979-7072, emailed to [email protected], or mailed to: 13931 Balboa Blvd., Sylmar, CA 91342 Children's Hunger Fund Effective: 05/09/2013 Volunteer Specialist Application Page 2 of 2