Become a Welcome Baby Volunteer
First Name
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Last Name
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Birth Date
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Marital Status
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Ethnicity
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Mailing Address
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City
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Zip Code
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Home Phone
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Work Phone
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Cell Phone
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Can you be called at work?
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E-Mail Address
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Languages Spoken
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Do you drive?
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Do you have an automobile available to you?
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What type of volunteer would you like to be?
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How many families would you like to visit?
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Approximately how much time per month can you contribute monthly and how long do you think you will be available to volunteer as a home-visitor?
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In what cities are you willing to visit families?
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Personal References
Please list two or more credible references we can contact to ensure the sustainability of our volunteers in the Welcome Baby program. Please list people who know you well enough to give credible feedback about your ability to work with others and their children.
Reference 1:
Name
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Phone Number
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Relationship
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Reference 2:
Name
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Phone Number
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Relationship
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Reference 3:
Name
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Phone Number
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Relationship
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The persons listed above are reliable sources that I give approval to be contacted with regards to my service as a Welcome Baby Home Visitor. Please print your name for verification:
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Optional Experiences:
Do you have any experience or training in the following areas?
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Education
Enter the highest completed. (This information will be used for applying for grants.)
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Major
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Degree
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What other kinds of paid and nonpaid work have you done?
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Once you've answered the questions, please press the "Submit" button to send us your Welcome Baby volunteer application.

© 2010 Children's Service Society | 124 South 400 East, Suite 400, Salt Lake City, Utah 84111
Phone: (801) 355-7444 | Toll-free: (800) 839-7444
Free Child Care Referrals: 801-355-HUGS (4847) or 1-866-GET-HUGS (438-4847)