Volunteer Application

Demographic Information

This information is used for statistical reporting purposes and to help us get a better idea of the demographic make-up of our volunteers.

About You

Please list 3 people you would like to use as a reference:

Previous Experience


By typing my name below I hereby attest to the truthfulness of all information listed on this application. I agree to authorize Zoie's Place to contact the references listed on this application. I understand my responsibilities as a volunteer and agree to be committed to the best interest of the participants of the Zoie's Place program. I agree to keep confidential all information I learn about the residents of Zoie's Place as well as his/her family.

Photo Release

I understand that by typing my name below, I hereby consent to the use of my name, likeness and speech in any audiotape, videotape, film, photograph, or electronic transmission or display made during the course of the Zoie's Place volunteer opportunity for any business purpose.

Criminal History

To the best of my knowledge, the information provided is true and complete. I understand that any falsification or omission of information may disqualify me for this position. By typing my name below I hereby provide my authorization to Zoie's Place to conduct a criminal background check.