Haven Volunteer Info

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Thank you for your interest in volunteering with The Haven of NEA, Inc. as we work tirelessly to end the cycle of domestic violence in Mississippi County, Arkansas.

Because of the population that we are serving, those interested in volunteering must go through a training program as well as a background check. If anything comes up (previous criminal record, Etc.) that will be handled on a case-by-case basis but does not automatically disqualify you from our volunteer programs.

Email *

First Name: *

Last Name: *

Address:

City, State, Zip:

Phone:

Message Phone:

Email:

DOB

YYYY

Employer:

Employer's Address:

Prior Volunteer experience:

Previous domestic violence experience:

Volunteer Interests:

Transportation of Donations

Inventorying and organizing donations

Cleaning and preparing housing units

Organizing children's activities

Fund raising activities

Simple maintenance

Painting

Answering Hotline calls

Occasional child care

Mentoring women

Represent at Event booths

Driver's License #:

Have you ever been convicted of a felony or misdemeanor? *

Yes

Please Provide three (3) personal or professional references: (Name/Phone/Relationship)

Reference #1 (Name/Phone/Relationship): *

Reference #2 (Name/Phone/Relationship): *

Reference #3 (Name/Phone/Relationship): *

T-shirt size:

I understand that my acceptance as a volunteer with The Haven is subject to favorable, routine inquiry of local law enforcement records. I do attest that the information I have supplied is true to the best of my knowledge. I understand that the provision of false information is grounds for my immediate dismissal from The Haven's volunteer services.

Please type your complete name to serve as your signature.

Comments:

Send me a copy of my responses.

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