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	Volunteer Application
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	MLK Day of Service 2012

Red Cross News

Stand Down Service Fair Scheduled

The American Red Cross has partnered with the Wayne D. Horner Memorial Stand Down to offer a Stand Down program on Saturday, October 8, 2011 Madison Armory, 1420 Wright Street, Madison, WI

Help is On the Way for New York

This morning, Friday, August 26, 2011, the local American Red Cross Emergency Response Vehicle will be leaving for New York in preparation of Hurricane Irene. Volunteers, Denise Davenport of Cambrid

Red Cross Assists Residents of Apartment Blaze

Six volunteers from the Badger and South Central Wisconsin Region of the American Red Cross responded to assist residents affected by today’s early morning blaze at in Madison. The apart

Red Cross Responds to Fire in Rock County

A trained relief volunteer responded to an apartment fire in Beloit, Wisconsin on June 26, 2011. At about 6:00 AM, the American Red Cross received a call requesting assistance for one tenant who was

Volunteer Application

Steps to Begin Volunteering with the Red Cross - Badger Chapter:

1) View our current Volunteer Opportunities

2) Complete the Volunteer Enrollment Form

3) Sign and submit the Volunteer Signature Forms (PDF) or (Microsoft Word). The Word document is fillable; can be completed, saved and submitted with Volunteer Enrollment form online.

4) Complete the Online Orientation which will provide an overview of the work of the Red Cross

5) Review and Complete the Volunteer Handbook

Volunteer Enrollment Form

Please review current volunteer opportunities before submitting form.

Contact Information

Legal Name [First, Middle, Last]:*

Preferred Name:

Street Address:*

City:*

State:*

County:*

Zip Code:*

Primary Phone:*

Secondary Phone:

Email Address:

Age Group

14 - 18 19 - 24 25 - 65 65 - Over

Emergency Contact Information

Contact [First, Last Name]:*

Relationship to You:*

Address:

Contact Phone [Days]:*

Contact Phone [Evening-Weekend]:

Education

(Highest Level Achieved)

Name of Institution:

City/State:

Degree/Major:

Occupation History

Current Occupation:

Current Employer:

If Retired or Unemployed, Please List Your Most Recent Employer:

Have you served in the US Military? If yes, what branch of service?*

Current Licenses and Certifications

(Other than those recieved through the Red Cross)

Valid Driver's License (required for certain volunteer assignments)

Yes No

Are you a licensed Mental Health Professional?

If yes, State and Expriation Date:

Are you a licensed Health Care Professional?

If Yes, State and Expiration Date:

Other:

Skills and Availability

Describe language proficiencies you have.*

Describe any computer skills you have.*

Describe any special skills and experiences:

Do you have previous Red Cross experience? If so, where, how long and what position[s]?*

How often and when are you available to volunteer?*

American Red Cross Volunteer Areas:

Please review current volunteer opportunities and select those that interest you in any categories.

Community Development

Support mission-related programs through community and financial development!

Database Assistant
Communication/Marketing
Philanthropy Committee

Disaster Services

Support Disaster Services through office related activites!

Casework Support
Logistics/Inventory
Disaster Staff Services
Microsoft/Access Support

Support Emergency Services by responding to disasters:

Disaster Action Team (local response)
DSHR Responder (Large Scale)
Public Affairs/Media
Disaster Health Services
Disaster Mental Health Services
ERV Driver (Emergency Response Vehicle)
Government Liason
Financial/Statistical
Mass Care (Sheltering, Feeding, Bulk Distribtuion)

Other:

Health and Safety

Support Health and Safety Programs through office related activites:

Instructor Coordinator
Logistics Assistant
Sales Assistant

Support Health and Safety by teaching life saving courses:

First Aid/CPR/AED Instructor
Babysitter Instructor
Compression-Only CPR Instructor

Volunteer Services

Assist the Volunteer Services department in processing applications, volunteer recruitment, outreach and recognition!

Administration/Recruitment/Recognition
Community Preparedness Education

Service to Armed Forces

Aid active Military Troops and provide services to our veterans!

Military Caseworker
VA Hospital Support
Military Event Support

Other:

Blood Services

Assist the Blood Services Department at Blood Drives!

Support Blood Drives
Administration
Warehouse

What is your motivation to volunteer?

Volunteer Internship Career Experience School Credit/Requirement Social Benefit Interest in Volunteerism Court Mandated Service Other

How Did You Hear About the American Red Cross Volunteer Program?

Select all that apply.

Application Verification

I authorize agents of the American Red Cross to check the references I provided and check with the appropriate public authorities regarding my background and history. I certify that the information in this application is correct to the best of my knowledge and belief. I understand that should I be offered a volunteer position, any misrepresentation by me may lead to termination. I also understand that my volunteer service can be terminated with or without cause and / or notice, at any time by either the American Red Cross or myself.

If accepted, I will abide by the rules and regulations of the American Red Cross and the Badger Chapter. I understand that completing the application process does not guarantee acceptance as a volunteer.

Authorization*

Read and Sign Red Cross Signature Forms

Signed Forms Needed: Confidential Information/Intellectual Property Agreement, Information Release, Code of Conduct, and Self Identification Forms.