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Serving Senior Citizens in Our Community

VOLUNTEER
APPLICATION

3640 N 5th Street, Suite 130
North Las Vegas, NV 89032

ID:
OFFICE USE ONLY

GENERAL And PANTRY VOLUNTEER APPLICATION

Name

Application Date

Address

DOB

City

Zip

Gender

Age

Select Contact type

Cell Work Home

Enter Number Here

Alternate Phone

Cell Work Home

Enter Number Here

Preferred Communication

Call Text Email

Enter Your Email

Emergency Contact

Phone

Address

City

Zip Code

Relationship

Do you prefer

Morning Afternoon

Are you interested in bringing your children to volunteer?

Yes No

Does your employer have an Employee Volunteer Incentive Program?

Yes No

Have you recently gone through or hold any current certifications that required a state or federal background check?

If yes, please explain:

Briefly explain why you are interested in volunteering with HHOVV and what you hope to achieve from the experience:

Are there any additional details or special considerations you would like us to know about? (Physical limitations? Skills? Specific areas of interest?)

Do you have any volunteer experience? If yes, please describe

How did you hear about us?

Do you speak Spanish?

Any other language?

Would you like information about HHOVV’s other Volunteer Opportunities?

Yes No

Volunteer Signature

Date

VOLUNTEER PANTRY DRIVER SECTION

Please complete if you want to be a Volunteer Driver

Driver’s License #:

Exp Date

Issuing State

Car is Insured with:

Exp Date

Year

Make

Model

License Number

Will there be a child under the age of 12 driving with you during deliveries?

Yes No

Age

If Yes, child’s name

Does the child live with the registered volunteer?

Yes No

List 2 persons whom we can contact for references (no family, please)

Name(Person 1)

Phone(Person 1)

Relationship(Person 1)

Name(Person 2)

Phone(Person 2)

Relationship(Person 2)

OFFICE-ADMIN VOLUNTEER SECTION

Please complete if you want to be an Office/Admin Volunteer

Are you able to sit to make telephone calls?

Yes No

Do you have experience in any of the following

Filing Word/Excel Data input Telephone

Other Areas of Experience

Can you operate a computer?

Yes No

Are you willing to go through required background check?

Yes No

Do you Speak Spanish?

VOLUNTEERAPPLICATION

GENERAL And PANTRY VOLUNTEER APPLICATION

VOLUNTEER PANTRY DRIVER SECTION

OFFICE-ADMIN VOLUNTEER SECTION

We’re Open at Our New Location!

HHOVV Nutrition Services are now available at: 3680 S. Maryland Parkway, Suite 526 Las Vegas, NV 89169

Located next to Goodwill and the One World Interactive Aquarium entrance.

Service Hours: Monday through Thursday 8:00 AM to 2:00 PM

We look forward to welcoming you to our new space!

Our food distribution will begin again on Monday, January 12th at the Senior Hunger Campus -Three Square. *If you need immediate assistance, please call Nevada 2-1-1 for support.

VOLUNTEER
APPLICATION