HOPE COMMUNITY RESOURCES INC. VOLUNTEER APPLICATION 540 W. International Airport Road Anchorage, Alaska 99518-1110 (907)561-5335 Fax (907)564-7429 Applicant Instructions Please Read the Instructions Before Completing Application Hope Community Resources, Inc Human Resources Network 540 W. International Airport Road Anchorage, AK 99518-1110 Telephone: 907-561-5335 Toll Free: 800-478-0078 Fax: 907-564-7429 Website: www.hopealaska.org

The mission of Hope Community Resources, Inc., shall be to provide services and supports, requested and designed by individuals and families who experience disabilities, resulting in choice, control, family preservation and community inclusion. Personal Data Date: Emergency Contact(Name and Telephone No): Current Occupation: Last Name: First Name: Middle: Address: City: State: Zip: Home Phone: Email: Cell/Message Phone: Date of last tine test or chest x-rays & results: Are you a U.S. Citizen? Yes No If no, do you have the legal right to live and work in the U.S.? Yes No Visa Type: Number: Expiration Date: Availability Morning Afternoon Evenings Monday Tuesday Wednesday Thursday Friday Saturday Sunday Do you wish to make a commitment: Yes No If so how long: Volunteer Interest Direct assistance with residents Daily Living Skills Cooking & Bathing Reading Self-Advocacy Sign Language Mobility Music Transportation Arts & Craft Parent Relief(for Foster Parents) Playing with residents(to develop sensory/motor skill) Outings(trips to shows, church, social functions) Other(Explain): Note: If you are interested in volunteering in our assisted living homes, you must be at least 16 years old. Assist with programs: Walk & Roll for Hope Other Fund Raising Activities Community Education Clerical Assistance Landscaping, Gardening Mending & Sowing Inventory Newsletter Library Publicity Recruiting Volunteers Other(Explain): Note: If you are interested in volunteering in our assisted living homes, you must be at least 16 years old. Are you related to anyone presently employed by Hope Community Resources, Inc.? If yes, to whom: Have you worked/volunteered at any time in the past with this agency? Yes No If yes, When? How did you learn about our agency? Hope Employee    Hotline    Job Services    Friend    Job/Career Fair    Newspaper    University    Internet Website    Other: Educational/Professional Information Schools Name of School/Address Course of Study From To GED,Degree or Highest Grade Completed High School College or University Graduate School Business or Trade School Have you ever worked with a developmentally disabled person before? If yes, please explain: (Student Volunteers, please attach your curriculum vitae) Age group with whom you like to work: Children, 5-12 Teenage, 13-18 Adult 18+ Severly developmentally/physically disabled Why do you want to volunteer at hope? What is your purpose? What do you wish to gain from your experiences with hope? (What are your expectations?): Personal/Professional References   Name Address Contact Phone(with area code) 1. 2. 3. List any significant skills, certificates, licenses, honors, professional affiliations(Sign Language, teaching certificate, etc.) and office equipment you can operate which may be applicable to different volunteer oppurtunities: Driver's License Number: State Issued: Expiration Date: Criminal History Received. All volunteers working in a home directly with an individual must have a criminal history check. Fingerprints received. All volunteers working in a home directly with an individual must be fingerprinted.