OLM Outreach - Serving James Island, Johns Island, Wadmalaw Island and The Neighborhood House of Charelston (Downtown) Our Lady of Mercy Outreach on Facebook

Volunteer Application

This application is for those wishing to volunteer locally at our Outreach & Wellness Centers and at the Neighborhood House.

Applicant Information

Applicant's Name: A value is required.Required
Address: A value is required.Required
City: A value is required.Required
State Please select an item.Please select an item.
Zip A value is required.Invalid format.RequiredInvalid format.
Phone: A value is required.Invalid format.
Alternate Phone: Invalid format.
Email Address: A value is required.Invalid format.RequiredInvalid format.
What is your highest level of education? Please include any additional degrees and your area(s) of study: A value is required.Required
If applicable, where are you employed and in what capacity?
If applicable, what professional positions have you held?
Have you worked as a volunteer before?
Please make a selection.
Special skills or talents you offer as a volunteer?
Why would you like to volunteer? A value is required.Required
   

Time Preferences

 

Select days preferred: Minimum number of selections not met.Maximum number of selections exceeded.Minimum number of selections not met.

Select times preferred: Minimum number of selections not met.Maximum number of selections exceeded.Minimum number of selections not met.

  

Areas of Interest

Select areas of interest:




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Emergency Contact Information

Person to notify in case of emergency

Name: A value is required.Required
Phone: A value is required.Invalid format.RequiredInvalid format.
Alternate Phone: Invalid format.RequiredInvalid format.
Relationship to you: A value is required.Required
   

Medical Information

Primary Physician's Name:
Phone: Invalid format.

Volunteer Release Agreement

As an unpaid volunteer, I hereby release and hold harmless Our Lady of Mercy Community Outreach Services, Inc. from any and all liability for any and all damages or injuries that may result to myself or my property as a result of assisting Our Lady of Mercy Community Outreach Services, Inc., to carry out its charitable purposes.

Please make a selection.I Agree. I have read the Release, which has been explained to my satisfaction, and I hereby knowingly, voluntarily and free of any coercion or duress by anyone, sign the Release. Please make a selection.I Agree. Believing that Our Lady of Mercy Outreach Services, Inc. has a real need of my services as a volunteer worker who serves without pay, I will uphold the tradition and standards of Our Lady of Mercy Services. Please make a selection.I Agree. I authorize Our Lady of Mercy Community Outreach Services, Inc. and its agents to photograph and video me. I understand that the images may be ditributed to various outlets without compensation.

Signature: A value is required.RequiredMinimum number of characters not met.
  Date: A value is required.Invalid format.RequiredInvalid format.
 

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