Society of St. Vincent de Paul

Council of Seattle / King County

Community Service Application

PLEASE READ BEFORE CONTINUING WITH APPLICATION

Court-appointed & High School/College Community Service is available on a case-by-case basis to qualified applicants. Please review the position descriptions to determine what position you qualify for.
If you qualify, please complete this application and indicate the department to which you'd like to apply.

The Society of St. Vincent de Paul does not discriminate in the placement of volunteers on the basis of race, color, religion, national origin, sex, disability, age, sexual orientation, gender identity and expression, veteran status or any other class prohibited by local, state or federal law. No question on this application is intended to secure information to be used in a discriminatory manner. Your completed application will be reviewed carefully; but its receipt does not imply that your services will be utilized. Volunteer consideration necessitates that you meet all conditions required for the position for which you are applying.

* First Name:

* Last Name:

* Address

* City:

* State:

* Zip Code:

* E-mail:

* Please enter e-mail again

* Main Telephone:

* How were you referred to SVDP?

* What type of Community Service is it?

Court-ordered

High School/College

* How many hours do you need?

* What date do you need them completed by?

* Have you ever been convicted of a felony or released from prison within the last 10 years?
(Such convictions may be relevant if job related, but may not necessarily bar you from participating)

Yes

* Please explain:

* What times of day are you available?

Mornings

Afternoon

Evenings

* Please indicate the areas you have an interest in volunteering:

Food & Clothing Bank	Thrift Stores
Warehouse/Recycle Yard

If you are a member of a local parish and interested in more information about membership in your local SVDP Conference, please check here:

yes

EMPLOYMENT/VOLUNTEER EXPERIENCE
If you have employment or volunteer experience you would like us to know about, please include it below. This is very helpful in determining the best position to offer based on your skills and interests.

Employer/Organization

Job Title/Project

Contact Name

Contact Phone

Nature of work performed:

Employer/Organization

Job Title/Project

Contact Name

Contact Phone

Nature of work performed:

Please summarize special skills and qualifications that are relevant to the position:

* Are you 18 or older? (Applicants age 16-17 may volunteer with a signed parental consent form)

Yes

PLEASE FILL OUT BELOW

Mother's Name:

Father's Name:

* Phone:

* School:

* Grade:

* School Contact (Name/Phone#):

* Are you able to perform the essential functions of the volunteer job for which you are applying, with accommodations if necessary?

Yes

REFERENCES
Please provide at least 2

* Name:

* Phone:

* Relationship:

* Name:

* Phone:

* Relationship:

Emergency Contacts
Please provide at least one, preferably two

* Name:

* Phone:

* Relationship:

Name:

Phone:

Relationship:

It is understood and agreed upon that any misrepresentation by me in this application will be sufficient cause for cancellation of this application and/or separation from The Society of St. Vincent de Paul (“SVdP”). I give SVdP the right to investigate all references and to secure additional information about me from other sources, including a criminal background check. SVdP may require written confirmation from the court to verify the reason that community service has been ordered. I hereby release from liability SVdP and its representatives for seeking such information, and all other persons, corporations or organizations for furnishing such information.

The Society of St. Vincent de Paul does not discriminate in volunteer placement and no questions on this application are used for the purpose of limiting or excluding any applicant’s consideration for volunteer placement on a basis prohibited by local, state or federal law.

This application is current for only 60 days. At the conclusion of 60 days, if I have not heard from SVdP and still wish to be considered for volunteer placement, it will be necessary to fill out a new application. I understand that just as I am free to resign at any time, SVdP reserves the right to terminate my volunteer placement at any time, with or without cause and without prior notice.

* I understand the above disclaimer and confirm that the information contained herein is accurate to the best of my knowledge

I agree

* Indicates Response Required

Mon	Tues
Wed	Thur
Fri	Sat
Sun

None	10 pounds
20 pounds	30 pounds
40 pounds	50 pounds or more with proper equipment