Menu Apply To Volunteer At Bethany Home Fill out the form below to apply to volunteer at Bethany. You can also download a PDF version of our volunteer application to fill out and mail to 1226 Berlin Street Waupaca, WI 54981. Personal Information Full Name* First Middle Initial Last Address* Street Address Address Line 2 City Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Americas Armed Forces Europe Armed Forces Pacific State ZIP Code Home Phone Cell Phone* Email* Is it okay to text about volunteer shifts?* Yes No Emergency Contact Name* First Last Emergency Contact Phone* Are you 14 years of age or older?* Yes No Experience Have you volunteered before?* Yes No How did you hear about us?* Why are you interested in volunteering at Bethany?* Describe any previous work experience that may be relevant to your volunteer opportunities at Bethany.* How many hours will you be able to help?* Are the hours you entered per day, week, or month?* Day Week Month Can we contact you if we need additional help on a particular day?* Yes No Please fill out the hours you'll be able to volunteer.* Sunday Monday Tuesday Wednesday Thursday Friday Saturday Areas of Interest - Check all that apply* 1-1 Special FriendActivity AidBaking Demonstration or AssistantBingo AnnouncerBleu Barn AssistantChurch Service HelperConversationsDelivery DriverDriverEvening Activity AssistantGardnerHousekeeping AssistantMen's GroupOuting AssistantPedi-CabPet TherapyReading BuddiesSpecial Event AssistantSupport ClerkThrift Store AttendantValetWalking LeaderWomen's GroupWorkout Buddy Choose one of your areas of interest and give ideas of how you would like to help.* What are other areas of interest and ideas you have for volunteering?* Disclaimer & Liability Release I certify that the information given in this volunteer application is true and correct and has been given voluntarily. I understand that this information may be disclosed to any party with legal and proper interest, and I release the organization from any liability whatsoever for supplying such information. I understand that I will not be paid for my services as a volunteer at Bethany Home, Inc. Signature* Date* MM slash DD slash YYYY CONTACT US Email Bethany Home Phone:715-258-5521 Toll Free:800-310-5521 Fax: 715-942-1408 FIND US Location:1226 Berlin Street Waupaca, WI 54981 CONNECT WITH US NON-DISCRIMINATION POLICY Bethany Home, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, and protected veteran status. Read more here. © Bethany Home 2021 Website Design, Development, SEO, and Hosting by The BLU Group - Advertising & Marketing