International Rescue Committee
http://www.theirc.org
VOLUNTEER APPLICATION

The IRC appreciates your time in helping our organization and clients, and we thank you for your interest.  Please complete the application as thoroughly as possible.  The information provided in this application is confidential and for internal use only.  Thank you for your time in completing this application.

I. Contact Information and Availability

Name:
       
Address:

Home Telephone:
     
Business Telephone:
     
Cellular Telephone:
    
Email Address:

Best Time to Contact:
     
Preferred Method of Contact:

List the days and hours you are available to volunteer:

Approximately how many hours in total are you available (weekly/monthly)?      


II. Volunteer Information

EDUCATION
Please indicate name of school & city, number of Years of schooling, whether you graduated, and degree/area of study.

High School:
     
	     
     
College:
     
	     
     
Other (please specify):
     
	     
    
Special Skills, Qualifications, Trainings, or Certifications:
     


WORK/VOLUNTEER HISTORY

Please tell us abouty your last three jobs, including name, address, supervisor,dates, reason for leaving, and a brief description of your duties.
     


	     
     
          


	     
     
          


	     
     
     
REFERENCES: Please provide three references of persons not related to you

Name and Address	Telephone/Email	       How long and in what capacity have you known this person?
     
1.


2.	     
   
       
3. 

PLEASE PLACE AN "X" NEXT TO YES/NO

Are you now, or have you ever been, employed at IRC?		___ Yes	___ No
If yes, provide office location/dates:  
                      
Are any relatives currently or in the past employed by the IRC?	___ Yes	___ No
If yes, provide name/relationship:  
     
Have you ever been convicted of a crime?			___ Yes	___ No
If yes, please list the nature, the reason, and the date of conviction: 
      

III. Authorization to Check References
 

I,      , hereby authorize the International Rescue Committee ("IRC") to contact all my employment and educational references, and to inquire about, investigate and obtain copies of any records which relate to me from my former employers and educational institutions I have attended.  I hereby release IRC and all affiliated entities, as well as any person or institution that provides IRC with any information about me, from any and all liability whatsoever resulting from any such inquiry, investigation, or communication.




___________________________________________		_____________ 
Applicant Signature					Date



____________________________________________
Print Name
 

IV.  Volunteer Interests 

Please list all the different languages and the level of languages you speak (Novice, Intermediate, Advanced, Superior): 
Language		Level		Language		Level
     
	     
	     
     
Volunteer Interests (Rank by importance from 1-5, with 1 being most important):

     
Clerical/Administrative	     
Driving/Transportation	     
Public Speaking
Tutoring	     
Mentoring	     
Technical/Computer
Special Events	     
Training	     
Shopping
Translation	     
Donations Assistance	     
Internship
Other (please specify):        
How did you learn of volunteer opportunities at the International Rescue Committee, and explain why you are interested in working with refugees?

     



Is there a particular culture or group of refugees with which you would like to work and why?

     



Is there a particular age group or family size with which you would like to work and why?

     


If you do have any special requirements for volunteering (e.g. time sheet for college credit, or work) please explain the details?

     


Would you be willing to help collect donations, monetary or in-kind, for refugee families through your workplace, school, community group, or other group?  

___ Yes	___ No

If yes, please list organization(s) and type of donation(s):      




Would you be able to transport refugees using your     		___ Yes	___ No
private means of transportation?