Volunteer Application Step 1 of 3 33% First Name*Last Name*Email* Phone TypeMobileHomePhone numberStreet*City*State*Zip Code*Length of Time as Ohio Resident*Less than 5 yearsMore than 5 yearsDate of Birth* MM DD YYYY Area(s) of Interest*Baby CuddlingSupporting Moms and CaregiversCleaningLaundryOffice - AdministrativeFundraising/Event SupportMarketingOtherHow can you help? Use Ctrl key to select all that apply.Position Applying ForIf you are applying for a specific position please indicate it here. If you are willing to assist in any area related to your skills or interests this field can be left blank. Some positions will require individuals with skills or interests in multiple areas.Physical Mobility*YesNoAre you able to walk unaided and lift 40 lbs or more?Qualifications*Please write 4 - 5 sentences as to why you are qualified for the position for which you are applying.Why would you like to volunteer at Brigid's Path?*Please write at least 4 - 5 sentences as to why you would like to volunteer at Brigid's Path.How does a woman who took recreational drugs during her pregnancy deserve to be treated?*Please write at least 4 -5 sentences.Are you available to volunteer at least 3 hours per week?*YesNoApproximately how many hours per week would you like to volunteer?*Availability*WeekendsWeekdaysVery Early Morning (12 am - 6 am)Early Mornings (6 am - 9 am)Day Time (9 am - 6 pm)Evening (6 pm- 12 am)What days of the week and times are you available to volunteer? Use Ctrl key to select all that apply.What times work best for you for Volunteer Training? Weekday mornings Weekday evenings Saturday Education, Work, and Volunteer ExperienceWhat is the highest level of education completed?*Did not complete high schoolHigh School/GEDSome CollegeBachelor's DegreeMaster's DegreeAdvanced Graduate work or Ph. D.Relevant Professional CertificationsEmployment Status*Employed Full TimeEmployed Part TimeRetiredStudentUnemployedCurrent EmployerMost Recent EmployerSchoolAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Past Relevant Work or Volunteer ExperienceReferences & Emergency ContactPlease provide contact information for three non-relative references and one emergency contact.Emergency Contact* Name Name of a person to contact under emergency circumstances.Emergency Contact Phone*Reference 1 Name* First Last Phone*Email* Reference 2 Name* First Last Phone*Email* Reference 3 Name* First Last Phone*Email* Background CheckHave you ever been convicted of or pleaded guilty to any offense (other than a minor traffic violation)?*YesNoPlease provide details about the conviction.Are you willing and able to cover the cost of your own background check?*YesNoCost is approximately $30 for individuals who have been an Ohio resident for 5 years or more, cost is approximately $60 if lived outside of Ohio in the past 5 years.All volunteers are subject to fingerprinting and background checks. Conviction of some offenses as identified in OAC 5101:2-5-09 result in ineligibility to volunteer at Brigid's Path.
