Volunteer Application

18 Tower Lane • New Haven, Connecticut

Do you regularly use email?

Yes No

Current Employer or School

Are you retired?

Yes No

What was/is your profession(s)?

In case of an emergency please notify

2nd Emergency Contact

Community affiliation or club/organization memberships

Please list any other prior volunteer/work experience

Why do you want to volunteer?

Special skills, interests, hobbies, languages

When can you begin volunteering?

How often do you want to volunteer?

1x per week 2x per week 1x per month Other

Days and times available?

Reference 1 - Name & Phone Number (must NOT be a relative or spouse)

Reference 2 - Name & Phone Number (must NOT be a relative or spouse)

The Towers has my permission to contact references after I’ve been interviewed. My signature below commits me to upholding The Towers rules of confidentiality and residents’ rights. It also provides The Towers with consent to use my photograph and any video or audio recordings, and or stories. All information will be kept confidential.

Signature of Applicant

Are there any limitations on volunteering?

Please check off any activities that interest you

Join our mailing list!

18 Tower Lane • New Haven, Connecticut 06519
203-772-1816

Volunteer Application

Our Residents need…YOU!