Fond du Lac County Department of Social Services Volunteer Application 87 Vincent Street Fond du Lac, WI 54935 Phone: (920) 929-3448 Theresa.Menting@fdlco.wi.gov Contact Information Last First MI Name Street Address City/ State/ ZIP Code Home Phone Cell Phone Social Security Number Birth Date Number Driver’s License E-Mail Address Interests Tell us in which areas you are interested in volunteering (Please indicate by checking the appropriate boxes below): Mentor Program A Clerical Assist with Legal Guardian To Foster Care Relief – – – – formal matching of a office assignments as assist persons who, To give relief to foster young person in need of needed. because of their mental parents so that they guidance and disability, are not able may meet their own companionship with a to adequately provide personal needs responsible and supportive for their own care or adult. custody. Youth Tutor Assist Friendly Visitor – – Transportation area youth who are Offering clients – Providing transportation to struggling with their friendship and Fond du Lac County education. encouragement on an clients individual basis to meet family needs. Food Pantry Filling – Student Intern – food requests and Programs designed for delivering food to the college age students to main office or client facilitate necessary homes for families in experience in the Human need. (Must be able to Services field. lift 25 lbs.) Other (Please Specify): May we share your telephone number(s) with other Fond du Lac County volunteers and/or departments for volunteer scheduling purposes? Yes No
Volunteer Application Fond du Lac County Department of Social Services 87 Vincent Street Fond du Lac, WI 54935 Phone: (920) 929-3448 Theresa.Menting@fdlco.wi.gov Contact Information Last First MI Name Street Address City/ State/ ZIP Code Home Phone Cell Phone Social Security Number Birth Date Driver’s License Number E-Mail Address Interests Tell us in which areas you are interested in volunteering (Please indicate by checking the appropriate boxes below): Mentor Program – A formal matching of a young person in need of guidance and companionship with a responsible and supportive adult. Clerical – Assist with office assignments as needed. Legal Guardian – To assist persons who, because of their mental disability, are not able to adequately provide for their own care or custody. Foster Care Relief – To give relief to foster parents so that they may meet their own personal needs Transportation – Providing transportation to Fond du Lac County clients Youth Tutor – Assist area youth who are struggling with their education. Friendly Visitor – Offering clients friendship and encouragement on an individual basis to meet family needs. Student Intern – Programs designed for college age students to facilitate necessary experience in the Human Services field. Food Pantry – Filling food requests and delivering food to the main office or client homes for families in need. (Must be able to lift 25 lbs.) Other (Please Specify): May we share your telephone number(s) with other Fond du Lac County volunteers and/or departments for volunteer scheduling purposes? Yes No
FdlCoVolunteerApp.docx