Volunteer Application 2025 - Jessica’s House

Address *

Phone number *

Birthday *

Gender *

Allergies- Any specific allergies/medications. If none, please write none or N/A. *

Medical note

Volunteer Opportunities of Interest *

Internship

Group Facilitator

Office Assistant

Community Outreach

Greeter

Hospitality

Camp Volunteer

How did you hear about Jessica's House/who told you about Jessica's House? *

Please list your reason for applying *

What interests you most about Jessica's House? *

What previous volunteer experience have you had with children, teens, young adults or adults? *

Personal Grief Story (If applicable) *

Date of Death *

Languages Spoken *

English

Spanish

Portuguese

Assyrian

Punjabi

French

German

Chinese

Other

Languages Written

English

Spanish

Portuguese

Punjabi

Assyrian

French

German

Chinese

Other

Days Available *

Our groups typically occur in the evenings after 3 pm and later, but day time school groups and office support is available.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Other

Emergency Contact Information

First name of Volunteer's Emergency Contact *

Last name of Volunteer's Emergency Contact *

Emergency Contact Relationship *

Phone number of Volunteer's Emergency Contact *

Employment

Company *

Employer Phone *

References

Reference 1 Name *

Professional or Volunteer *

Email 1 *

Please note email is required.

Phone 1 *

Reference 2 Name *

Personal (non-family) *

Email 2 *

Please note email is required.

Phone 2 *

Reference 3 Name *

Volunteer or Professional *

Email 3 *

Please note email is required.

Phone 3 *

Internship Reference if applying for an internship

Internship Course Teacher or Instructor

Phone 4

Email 4

Please note email is required.

School Information

School Name

Awards, Diploma and/or Degrees Received

Volunteer Agreement and Certification of Information Provided

Please read carefully before signing. If you have any questions on this application, please ask for assistance. Believing that Jessica's House has need of my volunteer services I agree to:
-I understand that I will donate my personal time to Jessica's House without contemplation of compensation or future employment.
-I understand that applications will be collected on an ongoing basis and that I will be contacted 2 months prior to the training with a decision about if I am accepted for the next training dates.
-I understand that training is offered ONLY to those who intend to volunteer for at least one year.

I certify that the answers given by me to the foregoing questions and statements are true, correct, and without omission. I authorize Jessica's House to investigate and/or verify the foregoing information, which might assist them in determining my qualifications for volunteering by any reasonable means including a formal background check.

Signature (Please type in your full name to sign this form below) *