Council of Hearts Application

Our volunteers serve a vital role in fulfilling the wishes of children. They assist in generating support through special fundraising events and raising public awareness. This is your chance to touch the hearts of many. Simply fill out the Volunteer Application, and send it to the address below.

Volunteer Application

Name: ______________________________________________________

Address: ____________________________________________________

City: ___________________ State: ___________ Zip: _______________

Home Phone: _________________________

Business Phone: _______________________

Education / Training: ___________________________________________

List Skills that may be of help: ______________________________________________________________________________________________________________________________________________________________________________________________________

Why are you interested in volunteering? ____________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________

Prior Volunteer Experience? ____________________________________________________________________________________________________________________________________

Please list two references other than relatives:

1. ________________________________________________________________

2. ________________________________________________________________

Have you been arrested for a crime and / or incarcerated?

If yes, please explain: ______________________________________________________________________________________________________________________________________________________________________________________________________

In case of emergency, please contact:

Name: Relationship: ________________________________

Address: _________________________________________

City: ______________________ State: _______ Zip: ______

Phone: _________________________

I authorize Benefit4Kids to perform a background check if necessary for acquiring reference information and checking criminal background in my state of residence. I also certify that the above information is accurate and complete.

Signature Date: ________________________________________________

Office Use Only:

Interview Date: __________

Volunteer Activity: _______________________

Comments: _____________________________________________

Mail to:

Benefit4Kids Council of Hearts

C/O Andy Gehringer

P.O. Box 51

Linwood, MI. 48634