Volunteer Application

The following application is to be a volunteer in the 211 Call Center. If you are unable to fill out the form below, please email a brief message of interest including your contact information to our 211 manager, Olivia Jurgovan, at This email address is being protected from spambots. You need JavaScript enabled to view it..

Name(*)

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Date of Birth(*)

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Local Address(*)

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City / State / Zip(*)

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Phone(*)

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Secondary Phone

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Email(*)

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Occupation or Major(*)

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Are you able to fulfill the commitment of 120 hours (6-8 months) following the training? There are no exceptions to this requirement.(*)

Yes

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How soon are you available to begin training? (New classes start on the 1st and 3rd Monday of each month.)(*)

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What other time commitments do you currently have?(*)

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Are you age 18 or older?(*)

Yes

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What is the highest level of education you have completed? List college(s) attended and degree(s), if applicable. Although high-school students are ineligible, there are no minimum education requirements for adult volunteers.(*)

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Have you been convicted of any offense other than minor traffic violations? If yes, please list the offense(s) and the year it occurred:(*)

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Have you had a traumatic personal experience in the past six months which might affect your work at PATH? If yes, please describe.(*)

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Describe any experiences (life, work, education, volunteering) you have had which would help you to help others.(*)

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Please evaluate yourself honestly on the attributes below, from 1 (very low) to 5 (very high).

Empathy(*)

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Listening Skills(*)

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Communication Skills(*)

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Open-minded Attitudes(*)

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Positive Attitude(*)

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Relates Well to Others(*)

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Commitment(*)

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Punctuality(*)

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Flexibility(*)

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Self-confidence(*)

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Motivation(*)

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Desire to Help Others(*)

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Computer Skills(*)

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Time Management Skills(*)

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What doubts are in your mind as you prepare for this experience?(*)

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Why do you want to be a PATH volunteer?(*)

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Do you have any special needs?(*)

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I believe all of the above statements are true to the best of my knowledge.

Name/Signature(*)

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Date(*)

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United Way 211

Human Services Online Database

Comprehensive PATH Services