Friends of the Family Application Form

1 Start 2 Complete

First Name *

Middle Initial

Last Name *

Address

Street Address

City

State

Postal Code

Home Phone

Cell Phone

Social Security Number

Date of Birth

Month

Day

Year

Emergency Contact Name

Emergency Contact Phone

Types of Support

Donate goods and services

Cook Meals (Level 1)

Help with household tasks (Level 2)

Providing Transportation (Level 3)

Childcare (Level 3)

Social Activities with Youth (Level 3)

Mentoring with Youth (Level 3)

Other

Other Types of Support

Number of Hours Available to Volunteer Each Week

0 hours (Donations Only)

1-3 hours

3-6 hours

6-10 hours

10+ hours

Normal Available Times

What days and hours are you normally available?

How did you hear about the Friends of the Family Program?

References

First & Last Name

Phone

First & Last Name

Phone

Have you ever been convicted (found guilty) of a crime (including probation(s) before judgement), or are there any pending criminal charges awaiting a hearing?

Yes

Please describe all convictions, when they occurred, the acts and circumstances involved, and any information pertaining to rehabilitation. Attach another page, if needed.

Do you have any medical conditions that we need to be aware of that may interfere with volunteering?

Please describe your motivation for applying to become a Friend of the Family. What types of support are you most interested in providing?

Have you ever held a professional license? If so, what type? Where was it issued?

Leave this field blank

Contact Us

Marin County Children and Family Services
Phone: (415) 473-2200
Email: Contact Form

If you are a person with a disability and require an accommodation to participate in a County program, service, or activity, requests may be made by calling (415) 473-4381 (Voice), Dial 711 for CA Relay, or by email at least five business days in advance of the event. We will do our best to fulfill requests received with less than five business days’ notice. Copies of documents are available in alternative formats upon request.

Privacy