Online Application Form

To be considered, all applicable fields must be filled out

Personal Information

*Name:

*Address:

City/Town:

State:

Zip/Postal Code:

Country:

*Home Telephone Number:

Mobile Telephone Number:

*E-mail Address:

Date of Birth:
(All applicants must be at least 18 years old)

Gender:

Height:

Weight:

*For which term(s) would you like to come to the Institute?

Term 1 - Jan 1 - Feb 25 (8 weeks or January only)

Term 2 - February 26 – April 28 (9 weeks)

Term 3 - April 29 – June 23 (8 weeks)

Term 4 - June 24 – August 25 (9 weeks)

Term 5 - August 26 – October 27 (9 weeks)

Term 6 - October 28 – December 19 (8 weeks)

Have you ever attended programs at the Institute? (please list all and the dates)

Which Option books have you read and which tapes have you heard or viewed?
(All volunteers are required to read “Happiness Is A Choice” prior to beginning their volunteer term)

How did you learn about the volunteer program?

Please describe yourself. What are your best qualities, your limitations?
Are you flexible, energetic, enthusiastic and organized?

Are you currently facing any significant physical or emotional challenges?

Please describe three types of situations about which you get the most uncomfortable or unhappy.

Why do you want to volunteer at The Option Institute?

What do you think it will be like to live and work at the Institute?

What are your concerns in coming to work and/or live at the Institute?

Work Skills

(Please indicate skill level and add any specific comments)

Skill Type	Skill Level			Comments
Skill Type	None	Good	Strong	Comments
Carpentry / Construction
Computer (Please list all specific programs you are familiar with in the comments section)
Cooking & Food Prep
General Office
Grounds Maintenance
Housekeeping
Marketing
Phone Skills
Public Relations
Other Skills

Most volunteer work involves physical labor therefore we require our volunteers to be in excellent physical health. You may be involved in lifting heavy objects as well as being on your feet for long periods at a time. Would you be able and willing to perform such jobs? (Please explain why or why not)

Ideally, what job(s) would you like to do as a volunteer?

Please describe your present state of health, noting any physical or psychological conditions.

Are you currently on any prescription medication?
If yes, please give the name of the medication and the condition for which it is prescribed.

Have you ever been tested positive for tuberculosis or hepatitis?

Have you ever had counseling or treatment for alcohol or drug dependency?

Employment Experience

Please list information here about your most recent job.

Employer:

From:

To:

Address:

City:

State:

Zip:

E-mail:

Telephone Number:

Job Title:

Work Performed

Reason for Leaving:

Volunteer Experience: (Please list previous volunteer work performed)

Have you ever been convicted of a felony? If yes, please explain.
(Conviction does not necessarily disqualify an applicant from volunteering)

References (Do not include people related to you):

	Reference 1	Reference 2
Name
E-Mail

Agreement & Acceptance

I affirm that the information contained in this application is complete and correct. I also understand that submission of this application does not guarantee me acceptance into a volunteer term(s) and that I will be contacted for a phone interview after my submission of this application. If I am accepted into the program, I understand that I will be notified and I will receive an Acceptance Packet with additional information, including a list of essential items to bring as well as travel directions.
I agree Date 02 04 2012 dd/mm/yyyy


In addition, please send a recent digital photo of yourself and current resume (CV) to volunteer@option.org Please feel free to contact us anytime for more information. Email Volunteer@option.org Address The Option Institute Attn: Volunteer Department 2080 S Undermountain Road Sheffield, MA 01257, USA Fax Attn: Volunteer Department 413-229-3202