Volunteer Application

* Required

Personal Information
Volunteer Preferences
  • Office - Shepherd's Center
    Office - Senior Center
    Transportation Office
    Companion Sitting
    Driving
    Handy Person
    Project Joy
    FIA Weekend Respite
    Person-to-Person (visitation)
    Telephone Reassurance
    Mailings
    SeniorNet (teach basic computer skills)
  • Mon
    Tues
    Wed
    Thurs
    Fri
    Sat
    Sun
  • AM
    PM
  • Once a week
    Twice a month
    Flexible
  • As a volunteer for The Shepherd’s Center of Kernersville, North Carolina, I relieve said Shepherd’s Center of any liability due to accident or illness while performing volunteer services. I also hereby grant The Shepherd's Center of Kernersville permission to obtain a background check before having any personal contact with service recipient and periodic random record checks. By signature, I also agree that I have read and agree to the Volunteer Policies and Agreements (including Confidentiality Agreement, Publicity Release, and Volunteer Background/Acceptance/Denial Process).

References: (Please do not complete if already an active volunteer.) Please offer work references if you have a recent/current employer, minister or personal references who could speak of your ability to work with others.

Reference 1
Reference 2
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