Volunteer Application | UCP of Greater Dane County

Respite/Youth Resources Program Volunteer

Please complete this application if you are looking for a hands-on volunteer experience, working directly with clients supported by UCP in the Respite or Youth Resources programs.

APPLICANT INFORMATION:

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Are you age 18 or older? *

Yes
No

Do you rely on the city bus or other public transportation?

Yes
No

EDUCATION and EXPERIENCE:

What is the highest level of education you have completed?

Please list any relevant experience, training, or strengths that you would bring to this volunteer experience.

(Major, minor, relevant coursework, previous experience with people with disabilities, etc.)

REASON FOR VOLUNTEERING:

Please select all that apply: *

I want to give back to my community
This is an opportunity for me to share my skills/knowledge
I am volunteering to fulfill an academic requirement/receive course credit*
I would like to enhance my skills working with people with disabilities
Other**

*How many total hours are required to fulfill your course requirements?

*When is the deadline for completing your hours?

**Other reason for volunteering, please describe:

AVAILABILITY:

Please indicate the times you are interested in working by entering the exact times you are available to work each day:

Sunday:

Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Please share any additional, relevant information regarding your availability:

Include Length of commitment (one time, semester, school year, summer, etc.) and preferred frequency (occasionally, weekly, semi-weekly, etc.)

Please indicate the environments you would like to provide services:

Community-based
In a family's home

(You may select more than one.)

Which age group are you most interested in working with?

(Please check all that apply.)

REFERENCES:

Please list two individuals, other than your family, who are familiar with your character, skills, and/or qualifications.

Reference 1:

Name and Relationship: *

Email:

Phone:

Reference 2:

Name and Relationship: *

Email:

Phone:

VOLUNTEER WRITTEN INTERVIEW QUESTIONS:

Please answer the following questions to help us get to know you better and find the best volunteer opportunity to match you with.

What interests you about this volunteer position? *

What experience have you had with individuals who have disabilities? *

Please describe your feelings and experiences surrounding the inclusion of people with disabilities in the community. *

What support do you need to ensure a successful volunteer experience? *

All information contained in this application is true and complete to the best of my knowledge and belief. I understand that misrepresentations or omissions of any kind may result in denial of a volunteer placement or be cause for subsequent dismissal. *

I agree.