Contact Information

Title
First Name*
Middle Name
Last Name*
Country
Address
City
Postal Code
Email*
Confirm Email*
Phone

Volunteer Information

Would like to Volunteer
DOB(mm/dd/yyyy):
Education (List highest grade/degree completed):
Employer:
Occupation:
Employer Address:
Employer City:
Employer State
Employer ZIP:
Spouse's Employer
How did you hear about volunteer opportunities at Nora's Home?
Volunteer Experience (Organizations, Nature of Service, Dates):
Special Skills, Training, Hobbies and Languages:
Membership in Civic, Social and Religious groups-Name & Leadership position (if any)
Volunteer Availability Days*
  • Monday
  • Tuesday
  • Wednesday
  • Thursday
  • Friday
  • Saturday
  • Sunday

Please select a user defined field for volunteer skills. This field is not required and may be removed from the page.

Shift Time: *
  • 9am-12pm
  • 12pm-3pm
  • 3pm-6pm
  • 6pm-9pm

Please select a user defined field for volunteer interest. This field is not required and may be removed from the page.

How often can you volunteer? Please select one. (Each shift is three hours):*
  • Once per week
  • Twice per month
  • Other

Please select a user defined field for volunteer availability. This field is not required and may be removed from the page.

Volunteer Interest
  • Guest Service Representative
  • Administrative work
  • Chef of the Day
  • Housekeeper
  • Food Drive Volunteer
  • Cleaning/Laundry Supplies Drive
  • Special Activities Volunteer

Please provide three non-family references: 

 

Name 1:
Phone Number 1:
Name 2:
Phone Number 2:
Name 3:
Phone Number 3:
Have you ever been convicted of, or placed on deferred adjuction for any misdemeanor or felony offense in the last seven years?
  • Yes
  • No

Emergency Contact:

 
Name
Phone Number
Relationship
Additional Comments

Security Code

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Nora's Gift Foundation • PO Box 8350 • Houston, Texas 77288 • (713) 360-9309
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