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The ARK

Caring for Chicagoland’s Jews, One by One

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Volunteer Application

Contact Information

First Name: *

Last Name: *

Address: *

City: *

State: *

Zip: *

Home Phone: *

Business Phone:

Date of Birth: *

Cell Phone:

Email: *

Special Skills or Qualifications

Current Job and Employer: *

Health Restrictions, if Any:

Languages Spoken: *

Previous Volunteer Experience

Summarize your previous volunteer experience:

Availability

Times that you are available for volunteer assignments

Availability: *

Monday

Tuesday

Wednesday

Thursday

Friday

Sunday

Morning

Afternoon

Evening

Volunteer Areas of Interest

Tell us the areas in which you are interested in volunteering

Volunteer Areas of Interest: *

Attorney

Computer

Dentist

Driver

English Tutor

Food Pantry

Home Visiting

Interpreter

Mentor

Optometrist

Pharmacist

Phone Well-being Check

Physician

Psychologist

Reception/Clerical

Thrift Shop

Other

(please specify):

Emergency Contact

Person to Notify in Case of Emergency

Name: *

Relationship: *

Phone: *

Personal References (3 required)

Name: *

Relationship: *

Phone: *

Name2: *

Relationship: *

Phone: *

Name3: *

Relationship: *

Phone: *

Please tell us a little about yourself and your interest in volunteering for The ARK: *

Thank you for completing this application. Please submit your application by
clicking the “Submit” button. You may also print it out and mail or fax it to: Director
of Volunteers, The ARK, 6450 N. California Ave., Chicago, IL 60645; fax:
773.973.4362

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Illinois Nonprofit Organization - Community Funded
A Partner in Serving our Community, a Special Grant Recipient of the Jewish United Fund/Jewish Federation