Team Volunteer: (5 hours per month) to assist in the planning of the MSC program Event Volunteer: (3-5 hours during planning time) to assist in the planning of one program or event Virtual Volunteer: (work from home or office at your convenience) graphics, proof reading, writing On Call Volunteer: (2 hours for an event or project)

First Name

Last Name

Org./Group

Address

City

State

Zip

Work Phone

Home Phone

Email

Are you 18 or older?
 Yes No

Gender
 Male Female

Occupation

Volunteer Interest

Talents, Expertise or Passions:
Please list three you would enjoy
sharing with MSC

Please list any special hobbies

Any current or previous volunteer work?

Amount of time available to volunteer:
(this can be an estimate and you are
under no obligation based on your answer)
Number of hours per week: or
Number of hours per month:

Are you available to volunteer during weekdays?
 Yes No

Are you doing this to meet a school requirement?
 Yes No

Volunteer Agreement

As a volunteer of Main Street Clare, I agree to the following:

• I understand that as a volunteer, I will not receive monetary payment for my services.
• As a volunteer, I agree in advance to release Main Street Clare, Inc. from any liability (e.g., injuries to person,
  property, theft, etc.) arising out of my volunteer service.

For the purpose of my consideration as a volunteer, I authorize Main Street Clare, Inc. to verify the information stated on this application.

Signature of Volunteer or Volunteer Group/Church Representative

Date

Parent/guardian signature for volunteers under age 18
I have read and understand this application and I give my child permission to be a volunteer for Main Street Clare, Inc.. Additionally, I give permission for Main Street Clare, Inc. to consent to emergency procedures in the event that I cannot be reached.

Signature of Parent or Guardian

Date

Continued volunteer service is contingent upon fulfillment of volunteer responsibilities, maintaining professional conduct, and acceptable performance. Volunteers may be dismissed for good cause or for failure to perform.