Volunteer Application Of Compass
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6ACTIVITIES
VOLUNTEER APPLICATION FORM
F
:
__________________________
ACILITY
N
:
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___________________
_____________________
AME
First
Middle
Last
A
:
__________________________________________________________________________
DDRESS
C
/S
/Z
__________________________________________________________________________
ITY
TATE
IP
P
:
__________________________
HONE
H
?
OW DID YOU HEAR ABOUT US
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
S
P
(
/
)
CHEDULE
REFERENCE
PLEASE CHECK APPROPRIATE DAYS
TIMES
Days:
Monday
Tuesday
Wednesday Thursday
Friday
Saturday
Sunday
Morning:
________
________
________
________
________
________
________
Afternoon:
________
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Evening
________
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V
A
I
(P
)
OLUNTEER
CTIVITIES OF
NTEREST
LEASE CHECK WHICH VOLUNTEER AREAS INTEREST YOU
Assisting/leading with group or individual* programs in the following areas:
_______
Arts & Crafts
________ Reading to residents
________
Exercise Classes
________ Religious Programs
________
Holiday/Festive Parties
________ Wii
________
Bingo (calling/assisting)
________ Cooking Groups
________
Letter Writing
________ Table Games(dice/cards etc.)
________
Wheelchair Walks
________ One on One Visits
________
Manicures (apply polish)
________ Computer Word Processing
________
Trivia
________ Reminisce
________
Reading to residents
________ Gardening
________
Other:___________________________________________________________________________
*The facility requires a background check if the activities performed by the volunteer are not
supervised or are conducted one on one. Please speak with Activity Director for additional
forms.
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