Volunteer ApplicationInterested in joining us as a volunteer at Donna Lexa Art Centers? Get started by filling out the application below!You can also print a hard copy of the application here and mail it to us. Questions? Contact us at programmgr@donnalexa.org or 262-521-2292. Name * First Name Last Name Email * Phone * (###) ### #### Emergency Contact Name 1 * First Name Last Name Relationship * Phone * (###) ### #### Email * Educational History Provide the name and location of schools attended, years attended, and the degree(s) earned. * Employment History Name of Company (most recent) * Position * Duration of Employment * Supervisor * First Name Last Name Supervisor Phone * (###) ### #### Company #2 Position Duration of Employment Supervisor First Name Last Name Supervisor Phone (###) ### #### What else would you like us to know about your career and/or employment history? Volunteer History Have you volunteered before? * Yes No Please describe your experience as a volunteer. * Personal References Please list two references (post or present employers, teachers, volunteer supervisors, etc.). *We CANNOT accept family members or personal friends as references. Reference #1 * First Name Last Name Relationship * Phone * (###) ### #### Reference #2 * First Name Last Name Relationship * Phone * (###) ### #### Availability When are you available to volunteer? (Days/times) * Which locations are you interested in volunteering with? * Downtown Waukesha West Milwaukee Outreach Do you have reliable transportation for travel between sites? * Yes No Do you have a valid driver's license? * Yes No List any additional skills or trainings. Outside of volunteering, what do your interests and hobbies include? Why are you interested in volunteering for Donna Lexa Art Centers? * How did you hear about Donna Lexa Art Centers? * Have you ever been convicted of a criminal offense? (Please note that background checks are required for all volunteers.) * Yes No Do you benefit from any accommodations in order to complete everyday tasks? * Background Survey * I have strong knowledge in topics such as art therapy, art instruction, psychology, art and human development. Strongly Disagree Disagree Neutral Agree Strongly Agree I am comfortable working with people with disabilities including physical, cognitive and developmental disabilities and disabilities related to mental illness. Strongly Disagree Disagree Neutral Agree Strongly Agree I have knowledge of developmental learning patterns in adults Strongly Disagree Disagree Neutral Agree Strongly Agree I have knowledge about or am interested in learning about adaptive art. Strongly Disagree Disagree Neutral Agree Strongly Agree I accept suggestions readily and with an open mind. Strongly Disagree Disagree Neutral Agree Strongly Agree I have fun experimenting with artistic methods and mediums. Strongly Disagree Disagree Neutral Agree Strongly Agree I am willing and able to demonstrate sensitivity to each participant as an individual with a unique growth pattern. Strongly Disagree Disagree Neutral Agree Strongly Agree I am willing to become acquainted with policies, regulations, programs, and facilities of the site(s) community. Strongly Disagree Disagree Neutral Agree Strongly Agree I am willing and able to recognize my duties, responsibilities, and privileges in the site(s) I am assigned. Strongly Disagree Disagree Neutral Agree Strongly Agree I am willing and able to maintain a professional and ethical attitude toward all members of the site(s) community. Strongly Disagree Disagree Neutral Agree Strongly Agree Permission/Release Statement Permission: Periodically we have photos taken of students and volunteers at work for newspaper stories, special events, art exhibitions and Donna Lexa print/web materials. Please indicate your preference below. * I GRANT permission to have my photo used. I DO NOT GRANT permission to have my photo used. Signature * Date * MM DD YYYY Participation Agreement • I hereby authorize Donna Lexa Community Art Center to contact the named references to establish my suitability as a volunteer and I hereby release them and their company from all liability for any damage for issuing the same. • It is the policy of Donna Lexa Community Art Center to screen all prospective volunteers. While we try to place every applicant, we reserve the right to select applicants according to our needs and criteria. • I understand and respect the confidential nature of the information I might have access to in performing my volunteers duties for Donna Lexa Community Art Center. I understand that if I should accept a volunteer position, any misrepresentation by me could result in termination. Signature * Date * MM DD YYYY Thank you!
