Payne-Phalen District 5 Planning Council

MAKE A DIFFERENCE - VOLUNTEER WITH YOUR COMMUNITY AND DISTRICT 5

Volunteer Application for District Five -

If you aren't sure what you'd like to do but feel you can offer some time - just pick up the phone and call the District Five Office. We'll help you determine how your skills, interests and values can contribute to building our community!

Volunteer Application

Payne Phalen District Five Planning Council
1014 Payne Avenue
Saint Paul, MN 55101
(651) 774-5234 (Phone)
(651) 774-9745 (Fax)
d5-director@visi.com
Contact: Leslie McMurray, Director/Organizer
District Five Volunteer Application
Contact Information
Name

Street Address

City
ST
ZIPCode
Home Phone
Work Phone
Cell Phone
E-Mail Address

Availability To Volunteer
During which hours are you available for volunteer assignments?
___ Weekday mornings
___ Weekend mornings

___ Weekday afternoons
___ Weekend afternoons

___ Weekday evenings
___ Weekend evenings

Interests

Tell us in which areas you are interested in volunteering. Add to the list if your interest is not listed.
___ Office Administration (Records, Filing, Phone Reception, greet visitors, information and referral)
___ Recycling Program and Neighborhood Clean Ups
___ Community Gardening
___ Finance and fundraising
___ Community Development and Economic Planning Committee
___ Crime Prevention and Block Club Organizing
___ Neighborhood Action Committee (Welcome Kits, Crime Prevention, National Night Out, Youth)
___ Special Services (Legal consultation, organizational development, training)
___ Events (Planning and organizing special events, meetings and forums)
___ Field work (Door to door canvassing, community outreach, issue analysis and strategy)
___ Fundraising (Finance Committee, Grant writing, Prospect Research, Evaluation)
___ Marketing and Publicity (Media relations, writing articles, web resources, brochures, graphics)
___ Phone Reception and Outreach
___ Newsletter production (on-line and print communication to community stakeholders)
___ Volunteer coordination (Assist staff and Board with leadership recruitment and development)
___ Translation (Assist staff with both cultural and language translation – verbal, written and culturally specific outreach)
___ Youth work (Homework assistance, field trip chaperones, assist staff with job and life skills curriculum, provide respectful positive mentoring to young person living in District Five)
___ Transportation (Obtain defensive driving class and offer occasional transport to community participants)
___ Special Skills ( Example: Cooking, Mentoring, Construction, Tutoring, Cleaning or Maintenance, Sewing, Gardening, Small Business owner, recreation, providing hospitality, conducting research, etc.. Please list below.)



Your Unique Interests, Skills and/or Qualifications
Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.







Previous Volunteer Experience
Summarize your previous volunteer experience.

Person to Notify in Case of Emergency

Name
Street Address
City ST ZIP Code
Home Phone
Work Phone
E-Mail Address
Agreement and Signature

By 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.

Name (printed)

Signature

Date

Our Policy

It is the policy of District Five Planning Council to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability. This information will be treated with respect and confidentiality.

Thank you for completing this application form and for your interest in volunteering with us.

Note: If you'd like to have a printed application mailed to you - simply e-mail us with your request. Thanks!

Email us
d5-director@visi.com