Volunteer Sign Up

Name*

First Last

Pronouns

Email*

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

I would like to:*

Be a VOLUNTEER
Be an INTERN through a university or school program

I am representing a group.*

Yes
No

With which college are you affiliated

University of Akron
Stark State
Kent State University
Other

How many hours do you need to complete?

Group Name*

Number of Volunteers

I would like to focus my time supporting:*

Hope & Healing - Both or either agency
Battered Women's Shelter
Rape Crisis Center

We would like to focus our time time supporting:*

Medina County Shelter
Summit County Shelter
Where we are most needed

Which languages do you speak?

Proposed Project Date*

2nd Proposed Project Date

Project Start Time

:

Project End Time

:

Referred by

Group Mission Statement

What do you hope to gain from your volunteer experience?

List any special skills that you posses:

i.e. Spanish, ASL, web development, accounting, etc.

H&H Volunteers have a number of opportunities to choose from!

Advocacy
Outreach
UA Campus Support
Donations and Sorting
Office or Administrative Work
Other

Description of Proposed Project:

Beautification ( Cleaning, Organizing, Sorting Donations, Yard Work)
Survivor Based (Educational Programming, Pamper Night, Fitness Class)
Child Based (Picnic, Crafts, Party)
Other

Will you need a letter of verification?

Yes
No

I have another idea...

Can you commit to multiple training sessions and a background check in order to do direct service?*

Yes
No

Consent*

I understand and agree.

By submitting this application I accept the following terms:
I am responsible for obtaining a background check.
I must be at least 18 years of age to volunteer.

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