CWS Harrisonburg: Volunteer Application
General Information
First Name
Last Name
Email
Phone
Birthdate
Example: 01/01/1950
Home Address
Street
City
State
Please select...
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip Code
Occupations, Skills and Hobbies
Occupation
Company/Employer
Do you have any skills or hobbies that you can share with CWS and our clients?
Yes
No
Please describe.
Do you speak any languages other than English?
Yes
No
Please list them and describe your level of proficiency.
Volunteer Experience
Have you previously volunteered with CWS
Yes
No
How did you learn about our volunteer opportunities?
What motivated you to volunteer with CWS? Are you volunteering to fulfill a class requirement or community service?
Describe any experience you have working in a cross-cultural environment with language learners?
Availability and Schedule
Average number of hours per week you would like to volunteer
Please enter a number only, i.e. 3
First Date Available
Example: 01/01/1950
Your general schedule of availability
Example: Mondays, 3-4 p.m. Wednesdays, 9-11 a.m.
Would you be able to commit to an initial volunteer period of at least 3-6 months?
Yes
No
Transportation and Accommodations
Do you have your own transportation and auto insurance?
Yes
No
Do you have any physical conditions that may impact your activities?
Yes
No
Please describe.
Connections
Are you part of a Welcome Team or group of volunteers?
Yes
No
What is the name of the supporting organization or faith group?
List any other professional, civic or other organizations you belong to that you consider relevant to volunteering with CWS.
Emergency Contact
First Name
Last Name
Relationship to you
Phone
Volunteer Activities
Which of the following activities are you interested in and available for?
Office Support (Front desk, admin, legal team assistance, etc.)
Housing (Set up homes for new arrivals, set up water or electricity accounts, etc)
Hot Meal and Groceries (Provide during the arrival of a new family)
Client Transportation (Support for events, food pantry, clothing closet, appointments, etc.)
Survival Conversational English Tutors (Adults, in-home volunteer placement)
Youth School Tutors (K-12 students, In-Home Volunteer Placements, after school)
MYVA Mentorship (1 year commitment to mentor a high school age refugee)
Background Screening and Consent
Do you understand that you must pass a criminal background check and possibly a motor vehicle clearance to volunteer with CWS?
Yes
No
A fee of $36 is charged for every person for background screening. Would you be willing to pay for the cost of your own background check?
Yes
No
Signature
Date
Example: 01/01/1950
