YoungMoms Volunteer Application

Home Address

Person to Notify in Case of Emergency

Employment or Volunteer History

(past two jobs or past two volunteer experiences only)

MENTOR ONLY

If you indicated you would like to be a mentor, complete the following section, otherwise jump to the signature.

Personal References

Please list two people who know you well and who can attest to your character, skill and dependability. These should be people you have known for at least a year.

Mentor Match Information

Agreement and Signature

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

It is the policy of this organization to provide volunteer opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability. Volunteer role assignments are made in ways that best support our mission and the well-being of the young moms we serve.