Tuesday, October 3, 2017 at 11:16 AM
Become a Driver! 1 hour a day, delivering meals to our Kihei Home Bound. Sign up at Hale Kau Kau or call 808-875-8754 Mahalo!
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Hale Kau Kau Volunteer Participation Form

25 W. Lipoa St., Kihei HI 96753

Information
Name
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Address
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Phone --
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E-mail
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Date of Birth //
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*Must be 18 years or older to work in kitchen unless approved by Program Director
Emergency Contact
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Emergency Contact Phone --
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Emergency Contact Email
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1. What interests you about becoming a volunteer at Hale Kau Kau?
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2. How did you hear about the volunteer program at Hale Kau Kau? Word of mouth, Internet, church, school, friend, newspaper, etc.? Please be specific.
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3. Since there are children that frequent our church location, you will be required to complete a criminal background check and training in recognizing and preventing child abuse. Do you agree to go through this process? Yes or No.
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4. Have you volunteered at Hale Kau Kau before? If so, please list approximate dates.
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5. Is your volunteer experience a school, organization or company program requirement? If yes, please indicate the number of hours you must complete and the time frame that you need to complete the hours along with any other pertinent information:
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Name/address of organization:
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Hours required:
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Contact person & phone number
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Program end date:
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6. Please provide two personal/professional references:
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1) Name & Address: Relationship Phone Number Years Known 2) Name & Address Relationship: Phone Number: Years Known:
7. I would like to volunteer in the following areas:
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Categories: Kitchen; Driver**; Office; Special Events; Other: **If volunteering for driver, I understand and agree that I will need to have a valid driver's license and will provide a copy to Hale Kau Kau, and I will drive my own car. I agree to have $100,000/$300,000 in liability coverage and my insurance will respond/pay in the event of an accident.
8. Do you have any special talents that you would be interested in sharing with the Hale Kau Kau Program? i.e. special events, graphic design, photography, entertainment, etc.?
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9. Availability-Please note days and time you are available to volunteer. Kitchen schedules are 2:30 pm to 6:30 pm Monday-Friday. 1:30 pm to 5:30 pm Sat-Sun. Driver's pick up schedules are 4:00 pm daily.
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I would like to commit to a regular day and time, Yes or No. I cannot commit now but would like to be a substitute, Yes or No. I would be interested in assisting with occasional office work, Yes or No.
Submission
The information on this form is true and complete. If accepted as a volunteer, any misstatement or omission of fact on this form may result in suspension of my services. I grant permission to check my background and reference and release the parish, the diocese and all diocesan locations from any and all liability that may result. I further understand that all persons who will have contact with children or vulnerable adults are require to comply with Diocesan Safe Environment policies and procedures and are required to undergo a state and federal criminal background check.
Signature
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Signature: Date: Signature: (Parent or guardian must sign if applicant is under 18 years of age) Date:
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