Volunteer Application | Mansion Memories

Name*

First Last

Email*

Primary Phone*

Address*

Street Address City State ZIP Code

How did you hear about Mansion Memories?

Please indicate which service club you are affiliated with:

Assisteens
National Charity League
Redlands East Valley High School Key Club
Redlands High School Key Club
University of Redlands
U of R SPURS
U of R Alpha Phi Omega

Are you 18 years or older?*

We do not allow volunteers who are younger than 14.

Yes
No

Parent/Guardian Name*

Parent/Guardian Contact Number*

Will you be bringing any of your own children to volunteer with you?

Children who volunteer must be at least 14 years old.

Yes
No

Please list the names and ages of your children that will be coming with you to volunteer.

To add additional names, click the "+" sign.

Name	Age

EMERGENCY INFORMATION

Local Emergency Contact*

Name

Emergency Phone*

Relationship*

Insurance Company/Policy Number

Primary Doctor

Doctor's Phone

MANDATORY QUESTIONS

Have you ever been convicted of a criminal offense (felony or misdemeanor, except minor traffic violations)?*

Yes
No

Please explain:*

Have you ever been reported to a social services agency, law enforcement authority, child abuse registry, or similar organization regarding abuse or misconduct involving children?*

Yes
No

Please explain:*

Are there any other facts or circumstances in your or your background that would cause us to question your ability to supervise, guide and care for young people?*

Yes
No

Please explain:*

Do you have any friends or family members who volunteer for Mansion Memories?*

Yes
No

Please provide their name and phone number as a personal reference.

VOLUNTEER PREFERENCES

If you speak any language other than English, please list here:

Please list any special skills, interests or hobbies you can share with our program:

We will contact you before each events and find out how you want to volunteer at that time. By submitting this online Volunteer Form, you are releasing all information contained herein to the use of the Mansion Memories volunteer program.