Personal Information Name *
* Email *
Email will be the primary form of communication used by Family Service. If you do not have an email address, we will contact you by phone.
Phone * Best Time to Call Date of Birth * Month 1 2 3 4 5 6 7 8 9 10 11 12 Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Education, Training & Work Experience Please indicate your highest level of education * Which best describes your current employment status? *
Check all that apply.
Job Title Typical Work Hours Have you previously served as a volunteer with Family Service or another organization? * Organization Description of Volunteer Role Have you ever been convicted of a felony or misdemeanor? *
If yes, please be advised that conviction of a felony or misdemeanor by itself may not prevent or bar you from consideration for the Family Service workforce. Family Service takes into account other factors (e.g. age and time of offense, seriousness and nature of the violation, etc.).
Volunteer Interests How did you hear about volunteer opportunities with Family Service? * Are you interested in volunteering to fulfill a school or court ordered community service requirement? *
While we do accept volunteers with community service requirements, please note that the availability of these positions are limited and are determined by the needs of the agency.
Why are you required to do community service? * Name of high school * Please indicate school and course names * What sort of documentation will you need to verify your hours? How many community service hours are you required to complete? By when must the hours be completed?
Date Format: MM slash DD slash YYYY
Why do you want to volunteer with Family Service?
Please check all volunteer opportunities in which you may be interested. There may not be openings in all areas. If there is not an opening at the current time, you will be placed on a waiting list. CONTACT Helpline Listener
Respond to callers on the help line and National Suicide Prevention Lifeline. Training and regular supervision provided. Shifts are available 24 hours a day, 7 days a week.
Assist with occasional projects including grounds clean up and painting. Shifts are seasonal; depends on need.
Food Pantry Volunteers
Assist in stocking and maintaining Food Pantry supplies.
Drivers for Food Pick-Up to Stock Food Pantry
Volunteers are needed to do food pick-ups on a weekly basis and transport it to our Langhorne Food Pantry and/or the Homeless Shelter Food Pantry in Levittown. Must be able to lift up to 50 pounds, as volunteers will need to both load and unload bulk food items. A truck or SUV is needed, valid driver’s license is required.
Help prepare meals each day for the adults and children who call the Bucks County Emergency Homeless Shelter their temporary home, and package meals for our clients currently residing at a remote location to allow for social distancing during the current pandemic. We ask volunteers to commit to one shift every week or every other week, depending on your availability.
May include data entry, filing, assistance with mailings and copying. Shifts on weekdays between 9:00 AM - 4:00 PM.
Assist with our Back to School Drive, Holiday Gift Shop or other short term projects.
Describe any special interests or skills you would like to share.
When are you available to begin volunteering? * Which days and times are you available for volunteering? * Are there any health/physical factors that we should consider before assigning you a task? * Please describe health/physical factors that we should consider: Acknowledgements
I understand that Family Service may require a PA Child Abuse Clearance, PA Criminal Record Check and/or FBI Clearance in conjunction with this Volunteer Application. The cost of the FBI Clearance is currently $27.50. There is no charge for the other clearances.
I so acknowledge *
I understand that all Family Service sites are Tobacco-Free. Smoking and other forms of tobacco use by employees, volunteers, independent contractors and vendors will not be permitted in any building or on agency campuses, including parking lots.
I so acknowledge *
Emergency Contact Information Emergency Contact Name *
Emergency Contact Phone * Alternate Emergency Contact Phone References
Please list people not related to you, who know you well enough to serve as a reference.
Reference 1 Name *
Phone * Email
Reference 2 Name *
Phone * Email
Optional Volunteer Profile
The following information is optional for you to complete with this Application. Decisions regarding your selection as a Volunteer are similar to any employment decision made by the agency. Family Service is an equal opportunity employer and does not discriminate on the basis of the following demographic factors.
Gender Ethnicity Race
Check all that apply.
Signature Please read before signing.
Family Service is an Equal Opportunity Employer. Services and employment are provided in a nondiscriminatory manner, without regard to age, race, religion, national origin, sex, limited English proficiency, disability, sexual orientation, transgender status, protected veteran status or other non-job-related factors, including those persons who are primary consumers of behavioral health services.
My statements and answers in the foregoing Volunteer Application, and any attachments or addenda thereto, are true and complete to the best of my knowledge. I understand that false or misleading statements may result in my being disqualified for, or terminated from, volunteer service by Family Service.
Family Service is hereby authorized to investigate any information contained in this Volunteer Application or any information related to my business background.
Signature of Applicant *
Please type your full name in the space below. This will serve as your digital signature.