Volunteer Form - RMH near Lurie Children’s

General Information

Last Name*:

First Name*:

Birthdate*: MM/DD/YYYY (must be 18 or older)

Home Phone*:

Cell Phone:

Email Address*:

Street Address*:

Apt, Suite, Bldg. (optional):

City*:

State/Province/Region*:

Postal/Zip Code*:

Country*:

Emergency Contact

Name*:

Relationship*:

Home Phone*:

Cell Phone:

Street Address*:

Apt, Suite, Bldg. (optional):

City*:

State/Province/Region*:

Postal/Zip Code*:

Country*:

Availability

Please Choose All Available Times*
Monday MorningMonday AfternoonMonday EveningTuesday MorningTuesday AfternoonTuesday EveningWednesday MorningWednesday AfternoonWednesday EveningThursday MorningThursday AfternoonThursday EveningFriday MorningFriday AfternoonFriday EveningSaturday MorningSaturday AfternoonSaturday EveningSunday MorningSunday AfternoonSunday Evening

How often are you interested in volunteering?*
Once a WeekTwice a MonthOther

If you selected other, please explain:

Please select the activities you're interested in*:
Family Ambassadors (greet families, assist at check-in, give families a tour and help them acclimate)House Refreshers (organize the kitchen, collect donations, stock supplies, and clean linens)Meal HelperSpecial Event Volunteers

Personal References

First Reference

Name*:

Relationship*:

Phone*:

Street Address*:

Apt, Suite, Bldg. (optional):

City*:

State/Province/Region*:

Postal/Zip Code*:

Country*:

Second Reference

Name*:

Relationship*:

Phone*:

Street Address*:

Apt, Suite, Bldg. (optional):

City*:

State/Province/Region*:

Postal/Zip Code*:

Country*:

How did you hear about our charity?*

Why would you like to become a volunteer for Ronald McDonald House Charities of Chicagoland & Northwest Indiana?

What skills would you like to use in your volunteer role?

Please share any physical limitations so that we can place you in the best volunteer position.

Do you speak a foreign language? If so, which language(s)?

Volunteer Experience (e.g. community, civic,religious organizations):

Prior Volunteer Service #1

Organization:

Dates:

City:

Assignments:

Prior Volunteer Service #2

Organization:

Dates:

City:

Assignments:

Employment

Current Employer:

Position:

Dates Employed:

Street Address*:

Apt, Suite, Bldg. (optional):

City*:

State/Province/Region*:

Postal/Zip Code*:

Country*:

Have you ever pleaded or been found guilty of a felony or a misdemeanor (excluding traffic citations)?*
YesNo

If you answered "Yes" to the previous question, please explain:

Agreement

I hereby certify that the information in this application is correct to the best of my knowledge and belief. I authorize agents of RMHC®-CNI to check the references I provided.*
I AgreeI Disagree

I understand that should I be offered a volunteer position, any misrepresentation by me may lead to termination. I also understand that my volunteer service may be terminated with or without cause and/or notice, at any time by RMHC-CNI.*
I AgreeI Disagree

If accepted, I will abide by the rules and regulations of RMHC-CNI. I understand that completing this application process does not guarantee acceptance as a volunteer.*
I AgreeI Disagree