Availability

Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
Mornings	Mornings	Mornings	Mornings	Mornings	Mornings	Mornings
Afternoons	Afternoons	Afternoons	Afternoons	Afternoons	Afternoons	Afternoons
Evenings	Evenings	Evenings	Evenings	Evenings	Evenings	Evenings

Employment Information

I Am Employed Unemployed Retired	Employer's Name
Occupation	Employer's Phone
Work Shift 1 2 3
My employer offers a time-off program for volunteers Yes No	My employer offers a donation matching program Yes No

General Background

Why are you interested in becoming a volunteer at the Haas Foundation?
Do other family members volunteer at the HAAS FOUNDATION? Yes No	If yes, what are their names?
Have you ever previously served as a volunteer with us? Yes No	If yes, what years?
Do you volunteer for other groups? Yes No	If yes, where?

Education or Training

High School Graduate/GED	Current College Student
College Graduate	Degree
Trade or Business School	Field of Study
Specialized Certificate	Degree

Volunteer Area Preference

Volunteer Area Preference

Skills Inventory

Please select all skills that you have
General Office / Computer Software
Photocopying Expert Moderate Novice Willing to learn	Typing, WPM	Phones, single line Expert Moderate Novice Willing to learn
Bulk Mailings Expert Moderate Novice Willing to learn	Sorting/Filing Expert Moderate Novice Willing to learn	Phones - Multiple Lines Expert Moderate Novice Willing to learn
Materials Preparation Expert Moderate Novice Willing to learn	Graphics/Desktop Publishing Expert Moderate Novice Willing to learn	Clerical Project Management Expert Moderate Novice Willing to learn
Data Entry/Word Processing Expert Moderate Novice Willing to learn	Excel Spreadsheet Expert Moderate Novice Willing to learn	Other Software Applications
Web Design/Development Expert Moderate Novice Willing to learn	Powerpoint Presentations Expert Moderate Novice Willing to learn
Experience...
Teaching/Working With Children Expert Moderate Novice Willing to learn	Grant Writing/Research Expert Moderate Novice Willing to learn	Graphics Expert Moderate Novice Willing to learn
Teaching/Working With Adults Expert Moderate Novice Willing to learn	Public Speaking Expert Moderate Novice Willing to learn	Media/Public Relations Expert Moderate Novice Willing to learn
Event Assistance Expert Moderate Novice Willing to learn	Newsletter Production Expert Moderate Novice Willing to learn	Other
Driver's License #/State of Issue	Any moving violations in the past three years ? Yes No	Do you have a CPR & first aid certificate? Yes No
Other Skills/Special Project (describe what you propose)

References

Please provide 2 references from:
1. Employer, former employer, coworker	Name	Phone
1. Friend or relative	Name	Phone
*If volunteering in education, please list children's or non-profit organization references.

How Did You Learn About the Volunteer Opportunity?

From Haas Foundation Volunteer Please give name		From Haas Foundation Staff Member Please give name
From Haas Education Newsletter	From Haas Donor Newsletter	From the Haas Web Site	From volunteermatch.org
Other

Certification and Acknowledgement

I certify that all information submitted in this volunteer application, or in my resume, interview, or other information is true and complete and that I have not knowingly withheld any information that would affect my application to volunteer at the Saul and Dayee G. HAAS FOUNDATION. I understand that due to the confidentiality of donor records all volunteers will have a criminal history background check in their residing state. I give permission for this background check to occur and understand that this will remain confidential. In addition I give permission for two to three references to be done on behalf of the HAAS FOUNDATION.
Certify the above? Yes No
Have you ever been convicted of a felony (excluding any record or conviction that has been judicially sealed, expunged, eradicated, or dismissed?
Yes/No? Yes No	If yes, please explain

Verification Key: QOISOJ
Type Verification Key (Required)