Harmonium - Services that Promote Well-Being

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Volunteer Online Application
(This application should only be used by Adults 18 years of age and older. Minors should complete the downloadable application because they will need their parent or guardian’s signature on the application.)
* Denotes required field

Last Name* First Name* M.I.

Address*

City* State* Zip*

Day Phone* Evening Phone*

Email Address*

Emergency Contact Name*

Emergency Contact Phone* Relationship*

How did you hear about Harmonium?*

Do you need to complete community service hours or court-required service?* Yes No

If yes, how many hours?

Have you ever been convicted of any criminal offense?* Yes No

If yes, please describe.

Do you have any previous volunteer experience?* Yes No

If yes, please describe.

Do you require special accommodations as a volunteer?* Yes No

If yes, please describe.

What are your hobbies & interests*

Languages spoken.*

What are your special skills & talents?*

What would you like to get out of your volunteer experience?*

Experience: Current &previous volunteer / employed experience / please list three*

Company/School

Title & Responsibilites

From & To

Company/School

Title & Responsibilites

From & To

Company/School

Title & Responsibilites

From & To

References: Two personal references (other than relatives or friends)*

Name 1

Address 1

Phone 1

Name 2

Address 2

Phone 2

Availability: Please indicate the days of the week and times you are available.*

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Hours per week desired*

Length of commitment desired*

I understand that in applying for a volunteer position, the information which I have furnished in this form is subject to verification. I authorize contact of listed references. I understand that misrepresentation or omission of facts requested is cause for non-appointment as a volunteer. If appointed as a volunteer, I agree to abide by Harmonium's policies & procedures and will fulfill my volunteer responsibilities to the best of my ability.

By submitting this online application, I acknowledge that I am at least 18 years of age and am electronically signing the application.

I agree with the with terms stated above

latest news

2/17/2010 - Soles for Souls, Klassic Kids Shoe Drive

Harmonium's Klassic Kids Program Administrator, Heidi Sorour, inspired the programs at our Klassic Kids sites to participate in SOLES FOR SOULS. This was a donation campaign that collected gently used shoes of all sizes to be sent to the people of Haiti who lost so much after the disastrous earthquake in January.

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Administrative Office
9245 Activity Road #105
San Diego, CA 92126
T (858) 684-3080
F (858) 684-3181
info@harmoniumsd.org