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Shanti Volunteer Application

Thank you for your interest in our volunteer program and the work we are doing at Shanti to provide support to people who are living with the challenges of HIV disease and AIDS.

If you are uncomfortable answering any of the following questions on-line or if English is your second language, you may call us at (415) 674-4700 to schedule an oral interview.

All information on this application is kept confidential.
Today's Date:
Birthdate/Age:
Name:
Address:
City:
State:
Zip Code:
Home Phone:
Work Phone:
E-mail:
 
If employed, your job title:
If employed, your employer:
If student, your school:
If student, your field of study:
 
Emergency contact:
Address:
Relation to you:
Phone number(s):
 
     
Have you ever applied to be a Shanti volunteer? If so, when did you apply and for which program(s)?
 
How were you referred to Shanti?
 
Gender Identity:
Female     Male     Transgender/Of Trans Experience
 
Sexual Orientation/Sexual Affection:
 
Racial and/or Ethnic Identification: 
 
What languages do you speak?
 
What languages do you read and write?
 
Which of the following do you have? (check all that apply.)
Car     Truck     Driver's license     Auto insurance
 
       
1.   Which of the following are you applying for? (check all that interest you):
  Peer Support to Shanti Clients
  Client Activities Desk
  Client Workshops
  Fundraising
  General Office/Clerical
  Outreach/Special Events
    Other: 
 
2.   Your availability for volunteer work (check all that apply):
  Mon-Fri Sat/Sun  
  Mornings
  Afternoons
  Evenings
 
3.   If applying to be a Peer Support Volunteer:
Are you able to make at least a 6 month commitment to the Peer Support Program? yes       no
Can you commit to attending a once-a-month support group? yes       no
 
4.   Describe briefly why you are interested in the Shanti volunteer program, what you hope to gain, as well as contribute.
 
 
5.   Describe your current or previous volunteer experience(s).
 
 
6.   Describe any major life changes you've experienced in the past twelve months (entering a recovery program, loss, ill health, relocation/move, job, relationship, etc.).
 
 
7.   Are you in the first 6-12 months of a recovery program?
yes       no
 
8.   What are some of your other personal and/or professional obligations (e.g. family, primary care provider, and/or religious commitments)?
 
 
9.   Do you have any personal health concerns that might impact your work as a volunteer (i.e., chronic illness, allergies)?
 
 
10.   How has HIV/AIDS or other serious illness affected your life? (You do not need to have been directly affected to become a Shanti Volunteer)
 
 
11.   Our clients, staff, and volunteers come from many different backgrounds. They may include people of different ethnicities, genders, or sexual orientations, people who are active or recovering drug/alcohol users, or people altered by illness. How might you be challenged working with people who have different life experiences from your own?
 
 
REFERENCES:
  Name:  
  Telephone(s):  
  Years acquainted:  
  May we call this person?   yes       no
 

 
 


Shanti | 730 Polk Street | San Francisco, CA 94109 | (415) 674-4700
 
HIV/AIDS Services: 
Overview | Activities for Clients | The Drop-in Service Center | Care Coordination | Peer Advocacy | The L.I.F.E. Program
 
General Information | The Memory Project | Breast Cancer Services | Mind/Body Programs | Training and Consultation
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