Volunteer

Live-in Volunteer Internship Application

This is an application to serve as a Residential Community Intern at Raphael House. This is not an application for employment.

Acceptance in the program is conditional to the needs and capacities of Raphael House at the time of application.

Contact & Travel Information

Date of Application:

Length of Commitment:

Expected arrival date:

Expected departure date:

First Name:

Middle Initial:

Last Name:

Address:

City:

State:

Zip Code:

Home Phone:

Cell Phone:

Email Address:

Of what country are you a citizen?:

Emergency Contact

Name:

Address:

Phone Number:

Email Address:

Education

High School:

Location:

Graduation Date:

Major Field of Study:

College:

Location:

Graduation Date:

Major Field of Study:

Post Graduate:

Location:

Graduation Date:

Major Field of Study:

Trade, Business, Technical:

Location:

Graduation Date:

Major Field of Study:

Military Service

Branch of Service:

Length of Service:

Rank at Discharge:

Type of Discharge:

Volunteering

Volunteer Experience:

How did you first hear about the Live-in Volunteer Program at Raphael House?:

What if any, is your previous affiliation with Raphael House? :

Raphael House - Moving Families from Crisis to Community

Volunteer

Live-in Volunteer Internship Application