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Volunteer and Assistant Application
Please make sure you have contact information for three references and any other information you may need to complete the form before starting. Leaving the page will start the application process over.
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Indicates required field
Name
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First
Last
Age
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Please enter your age at the time of training.
Address
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Line 1
Line 2
City
State
Zip Code
Country
Phone Number 1
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Phone Number 2
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Email
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Communication Preferences
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Please let us know if you have an alternate address or other contact information and times when your communication preferences change.
Emergency Contact Information
Name
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First
Last
Phone Number
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Phone Number
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Availability
Please mark the RETREATS you are available for.
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July
August
September (18 and up)
Assignment Preference
Choose which positions you are interested in.
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Set-Up Crew
Runner/Helper
Assistant*
If you chose Assistant, which ages do you prefer?
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0-2
3-5
6-11
12-15
16-20
21+
Photo Permission
My intials typed below indicate my acceptance of the following. Wellness G.I.F.T.S., Inc. has my permission to use visual images with or without audio, which may be taken while I am at retreats for promotional, educational, or fundraising activities. I understand that these likenesses will be used to promote public awareness, understanding and support of the Wellness G.I.F.T.S., Inc. program.
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History
Have you been an Assistant or volunteered in another capacity for Wellness G.I.F.T.S.? If yes, please describe.
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Choose one
yes
no
Please provide dates and positions for which you volunteered in the past.
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Have you ever been convicted of a misdemeanor or a felony and do you have any pending criminal charges against you? If yes, please describe.
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Choose one
Yes
No
If you answered "yes" above, please explain.
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Will you be using your time at Wellness G.I.F.T.S. as an internship or community service commitment?
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Yes
No
Please tell us what interests you about being an Assistant.
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Please describe your experiences that relate to working with people who have special needs.
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Please list other volunteer experiences you have had.
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Please list other skills and experience you have that will benefit your work with our families.
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Please rate yourself in each of the following areas using the drop down boxes.
Accepting Responsibility
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Choose one
5- Excellent
4- Very Good
3- Average
2- Fair
1- Not a Strength
Emotional Stamina
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Choose one
5- Excellent
4- Very Good
3- Average
2- Fair
1- Not a Strength
Teaching Abilities
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Choose one
5- Excellent
4- Very Good
3- Average
2- Fair
1- Not a Strength
Adaptability
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Choose one
5- Excellent
4- Very Good
3- Average
2- Fair
1- Not a Strength
Team Player
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Choose one
5- Excellent
4- Very Good
3- Average
2- Fair
1- Not a Strength
Following Directions
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Choose one
5- Excellent
4- Very Good
3- Average
2- Fair
1- Not a Strength
Physical Stamina
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Choose one
5- Excellent
4- Very Good
3- Average
2- Fair
1- Not a Strength
Taking Initiative
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Choose one
5- Excellent
4- Very Good
3- Average
2- Fair
1- Not a Strength
Leadership
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Choose one
5- Excellent
4- Very Good
3- Average
2- Fair
1- Not a Strength
Please check any areas in which you are certified.
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Water Safety Instruction
First Aid
AED
CPR
Please list any languages other than English you speak.
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Is there a family with whom you prefer to work?
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References
If you are 18 or older or if you plan to complete an internship or community service commitment with Wellness G.I.F.T.S., please identify three professional or two professional and one personal references.
If you are under 18, please provide at least one professional reference (a teacher, someone for whom you babysat, for example) and two personal references.
Please include an address and either a phone number or email for each reference. We will call or email each reference and will mail a form if they are not available via email or phone.
Reference 1
Please indicate whether this reference is Professional or Personal.
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Professional
Personal
Name
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First
Last
How do you know this person?
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Email
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Phone Number
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Address
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Line 1
Line 2
City
State
Zip Code
Country
Reference 2
Please indicate whether this reference is Professional or Personal.
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Professional
Personal
Name
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First
Last
How do you know this person?
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Email
*
Phone Number
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Address
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Line 1
Line 2
City
State
Zip Code
Country
Reference 3
Please indicate whether this reference is Professional or Personal.
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Professional
Personal
Name
*
First
Last
How do you know this person?
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Email
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Phone Number
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Address
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Line 1
Line 2
City
State
Zip Code
Country
Please leave us any comments or questions.
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I agree to receiving marketing and promotional materials
Submit Volunteer and Assistant Application
Questions?
volunteer@wellnessgifts.org
, or text 607-684-3243
