Volunteer Application 

Thank you for your interest in volunteering at the Salem Mennonite Home. It is the policy of the Salem Mennonite Home to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability. Please complete our volunteer application below. 

You may also download a volunteer application by clicking here.

Name *
Current Address *
Current Address
Phone Number *
Phone Number
Availability *
When are you available to volunteer? Select all that apply.
Interest *
If you have a different interest from those listed above, please specify here.
Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.
Summarize your previous volunteer experience.
In case of emergency who should we notify? Please include their name, address and phone number(s).
By typing my first and last name in the space below and submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.
Volunteers are responsible for maintaining the confidentiality of all information to which they are exposed while serving as a volunteer, whether this information involves residents, staff, volunteers or involves any Salem Mennonite Home business. Failure to maintain confidentiality may result in termination of the volunteer's relationship with the Home. By entering your full name below you acknowledge that you understand.
Provisions of the Fair Credit Reporting Act require that we advise you that a routine inquiry may be made which will provide information concerning your character, reputation, personal characteristics and mode of living.  If such inquiry is made, you may obtain additional information as to the nature and scope of the report upon written request.