LOGAN-Resources and Opportunities for People with Disabilities
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Student Volunteer Application

Complete this online application or download a pdf application. Your email address is required.
First Name
Last Name
Email Address (required)
Phone
Campus Address
City, State, Zip
Date of Birth
Home Address
Do you have a car? Yes No
Education Information
School Name Class Year
Major Course of Study

General Information
Please list previous volunteer 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 a class? Yes No
If yes, please provide class name and professor:
Class name:
Professor:
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 other commitments, activities, clubs:
Please list two references:
Name
Address
Phone
Relationship to volunteer
Name
Address
Phone
Relationship to volunteer

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