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Did you Know?
Let's Do Lunch
Volunteer today for our Lunch Buddy/Lunch Pal Program.
Donations are always needed
See our donations page for ways to donate.
got friends?
Currently there are approximately 86 adults and children waiting for a Supportive Friend or Mentor.
An Evening of Chocolate Infusion
Save the Date - even better, sign up today! April 26, 2012 ~ Still $50!
Referring Professionals
click here
Compeer of the Mohawk Valley Inc., Online Volunteer Application
Today's Date: February 6, 2012
Name:Email:
Home Phone: Work/Cell Phone:
Is it OK to contact you at your w/c phone? Yes     No   
Address
Street:   
City:   

State:     Zip:  
DOB: Gender: Race (optional):
Marital Status: How did you learn about Compeer?:
Have you ever volunteered for Compeer Before?: Yes      No   
If yes, please give dates and program location:
What prompted your interest in volunteering for Compeer?:
If Applicable, please list all volunteer experience including work at churches, schools, boards, etc. Previous volunteer experience is NOT required for Compeer Volunteer Service.
Agency:
Dates:
Duties:
Agency:
Dates:
Duties:
Agency:
Dates:
Duties:
Education: Grade School    High School   College   Graduate School   Trade School   Military 
Are you currently a student: Yes      No   
If yes give name of school:
Please list hobbies/activities/interests (please be as detailed as possible):
Please list your last three employers starting with the most recent
Employer: Supervisor:
Phone: Dates:
Employer: Supervisor:
Phone: Dates:
Employer: Supervisor:
Phone: Dates:
Have you ever been convicted of any violation of the law except for minor traffic tickets? If yes, please give details and dates:
Do you have a valid Driver's License / use of a car?: Yes      No   
Do you object to a client that smokes?: Yes      No   
Do you have any preferences regarding your friend’s religious affiliation, location, or age etc.? If so, please explain:
Can you make a commitment of one year of service with Compeer?: Yes      No   
Which of the following volunteer opportunities most interests you?:
Please list two professional references (you may use clergy/teachers) and one personal reference.
Name: Phone:
Agency / Company: Relationship:
Address:
Name: Phone:
Agency / Company: Relationship:
Address:
Name: Phone:
Agency / Company: Relationship:
Address:
I certify that answers given herein are true and complete. I authorize Compeer staff to contact employment/personal references as indicated in this application. I understand that as a volunteer, I will help my friend to the best of my ability in accordance with the policies of Compeer. I will maintain complete confidentiality concerning information on Compeer clients. I further understand that submission of a completed application along with an interview and training does not obligate me to accept, or Compeer to assign a volunteer opportunity.