Volunteer Application .pdf

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The House of Amos
“Let Justice Surge Like Water” Amos 5:24
Volunteer Application – Please PRINT
First and Last Names: ___________________________________________________
Home Address: ________________________________________________________
City: ______________________________________ Zip Code:_________________
Home Phone: ________________ Work_______________ Cell _________________
Email: _______________________________________________________________
School / Organization Affiliation (if any): ___________________________________
Male [ ]

Female [ ]

*Date of Birth: ______________________ *Age ________

*Emergency Contact:
Name: ________________________________________

Phone:_________________

*Not required
Questionnaire:
1. How did you hear about the House of Amos?
_____________________________________________________________________
2. Why would you like to serve as a volunteer at the House of Amos?
_____________________________________________________________________
_____________________________________________________________________
3. What special talents, areas of expertise or experiences do you possess that can be used in
a non-profit organization such as the House of Amos? For example, are you bilingual?
Are you a certified teacher?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

Volunteer Guidelines and Policies
Volunteers are key to the success of The House of Amos’ ability to serve our clients. Volunteers
are needed to work in the Food Pantry as well as the Literacy department.
Food Pantry volunteers assist staff with filling food bags, maintaining and stocking pantry
shelves, distributing food and cleaning.
Literacy department volunteers assist staff with administrative work such as filing and data entry
and helping students in ESL classes. Volunteer teachers must have a four year college degree in
any major. Please see the literacy director if you are interested in teaching a class.
Discrimination Statement
The House of Amos operates in accordance with the Texas Department of Human Services
policy which prohibits discrimination on the basis of race, color, sex, age, disability, religion,
political belief or national origin.
Media Release
I hereby give my consent to be photographed while volunteering at The House of Amos. I
understand that any such photographs, including video recordings, become the property of The
House of Amos and may be used by The House of Amos for promotional purposes up to and
including displays on The House of Amos property and on Facebook.
House of Amos
Confidentiality Statement and Code of Conduct
All information generated at The House of Amos is private and confidential. No information
about any client or visitor utilizing services provided by The House of Amos will be shared with
others. Volunteers will conduct themselves in a business-like manner and treats others with
dignity and respect. Violation of the confidentiality statement or poor conduct at The House of
Amos will result in termination as a volunteer.
By signing below, I confirm that I have read and agree to the above Guidelines and Policies,
Media Release, Confidentiality Statement and Code of Conduct.
Volunteer’s signature: _________________________________________________________
Date
Parent’s signature: ____________________________________________________________
If volunteer is under 18 years of age, must have parent or legal guardian’s consent
Date
Accepted by HOA Representative: _______________________________________________
Date


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