Volunteer with Susie’s Place Susie’s Place is always grateful for volunteers to help us with a variety of tasks at either of our locations. If you’re interested in volunteering, fill out this form or contact Lynn Clinton. Volunteer Application We consider applicants for all volunteer positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, sexual orientation, the presence of a non-job related medical condition or handicap, or any other legally protected status. Step 1 of 4 25% Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Email* Phone*Phone (alternate)Are you a student?*YesNoWhat school do you attend?What is your field of study?Which of the following best describes your employment status?Currently UnemployedWorking Full-TimeWorking Part-TimeFull-Time HomemakerRetiredWho is your current employer, and job title?Are you 15 years or older?*YesNoBirth Month and Date (Do Not Include Year)Emergency Contact Name (1) First Last Emergency Contact Phone Number (1)Emergency Contact Name (2) First Last Emergency Contact Phone Number (2) Save and Continue Later Interest and AvailabilityAt which center(s) are you looking to volunteer?* Bloomington Avon Terre Haute Check any areas you're interested in helping with* Landscaping Bulk Mailing Education/Outreach Cleaning/Organizing Computer Work Donation Pick-Up/Delivery Holiday Activities Maintenance Moving Furniture Reception/Clerical Special Events Other What did you have in mind?What is your availability?* Daytime Evenings Weekends Only What days and hours are you available?When can you start? Date Format: MM slash DD slash YYYY Save and Continue Later Background InformationHow did you hear about Susie's Place?*List previous volunteer work*List any special skills, training, experience (business, professional, trade, etc.) that may be applicable to volunteering with Susie's Place.Are there any medical and/or physical conditions that would prohibit you from participating at Susie's Place as a volunteer?Why do you want to volunteer with Susie's Place at this time?*List any additional information, special interests, or experiences you feel may be helpful to us in considering your application.Have you filed an volunteer application with us before?*YesNoHave you been employed by or volunteered with us before?*YesNoHave you ever been convicted of anything more than a minor traffic offense? (Criminal history checks required prior to volunteering)*YesNo Save and Continue Later References and SubmissionReference Name (1)* First Last Relationship (1)*Parent / GuardianSiblingAunt/UncleCousinGrandparentCo-Worker / ColleagueFriendPhone (1)*Reference Name (2) First Last Relationship (2)Parent / GuardianSiblingAunt/UncleCousinGrandparentCo-Worker / ColleagueFriendPhone (2)Reference Name (3) First Last Relationship (3)Parent / GuardianSiblingAunt/UncleCousinGrandparentCo-Worker / ColleagueFriendPhone (3)I certify that I am the sole and responsible applicant and the information/answers given herein are true and complete to the best of my knowledge. I consent to and authorize Susie’s Place to complete reference checks by contacting the references provided above.* I Agree CAPTCHAEmailThis field is for validation purposes and should be left unchanged. Save and Continue Later This iframe contains the logic required to handle Ajax powered Gravity Forms.