LOGAN-Resources and Opportunities for People with Disabilities
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Volunteer Application

Complete this online application or download a pdf application. Your email address is required.
First Name
Last Name
Address
City, State, Zip
Date of Birth
Email Address (required)
Home Phone
Work Phone
Best time to reach you
Do you have a car? Yes
No
Education Information
School Name (current or most recent)
Major Course of Study (if college)
Graduation date

Experience
Please describe previous volunteer service experience

Have you had experience working with persons with disabilities? Yes No
If yes, please explain:
What do you wish to gain from volunteering at LOGAN?
Are you volunteering through an organization or class? Yes No
If yes, please explain:
Teacher/supervisor name:
How did you hear about LOGAN?
Have you ever been convicted of a felony? Yes No

If yes, please explain:
Please check interest areas or skills that you would be interested in sharing with LOGAN:
Best time for volunteer service (please include am or pm):
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Please list three references:
Name
Address
Home Phone
Work Phone
Relationship
Name
Address
Home Phone
Work Phone
Relationship
Name
Address
Home Phone
Work Phone
Relationship

LOGAN Community Resources, Inc.
2505 E. Jefferson Blvd. • South Bend, IN 46615
(574) 289-4831
logan@logancenter.org
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