• Home
• About Us
• Blog
• Programs
• News & Events
• How to Help
• Contact

To start the volunteer process, please:

1. Submit the Niles Volunteer Application form below AND
2. Submit a Worker Registration form. You can find the Worker Registration form on the Missouri Department of Health and Senior Services website. When filling out the Worker Registration form, make certain to list Niles Home for Children as the “employer” and Darlene Wigfall as the contact.
3. You will also need to have a current TB test on file with Niles Home for Children. We can test you here if needed.

Please call 816-241-3448, if you have any questions.

First Name: *

Middle Initial:

Last Name: *

Date of Birth: *

MonthJanFebMarAprMayJunJulAugSepOctNovDec

Day12345678910111213141516171819202122232425262728293031

Year19001901190219031904190519061907190819091910191119121913191419151916191719181919192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015

Street Address: *

Street Address 2:

City: *

State (Two letter state abbreviation. Ex: KS, MO): *

ZIP: *

Home Telephone: *

Mobile Telephone:

Work Telephone:

E-mail:

Emergency Contact (Person who can be contacted in an emergency.): *

Emergency Contact Telephone: *

Availability - What days/times are you available? (Weekdays, weekends, evening, daytime.) - Frequency? (weekly, month, other): *

Volunteer Areas (select at least two): *

Living Skills

Recreational/Activities

Teaching sports or games

Educational

Performing Arts

Office work

Reading/Tutoring (specify ages, topics in comments box below)

Other (please describe in the comments box below)

Volunteer Area Comments:

Connections. Can you help us get connected to your place of worship, business, civic or social club? Do you know of groups that will volunteer, offer resources or funding opportunities?:

Interests and Skills: *

Painter

Electrician

First Aid Trainer

Plumber

Graphics Artist

Athletic Coach

Carpenter

Newsletter

Public Relations

Teacher

Grant Writer

Photographer

Other (please describe in comments box below)

Interests and Skills Comments:

Most Interested in...If you have a strong interest or preference in volunteering in a certain capacity, please provide details here:

Criminal HistoryHave you ever been convicted of a crime? If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed and type(s) of rehabilitation. If no,: *

Personal Reference 1 Please provide Name, Address and Phone Number of person *not* related to you: *

Personal Reference 2Please provide Name, Address and Phone Number of person *not* related to you: *

CAPTCHA

This question is for testing whether you are a human visitor and to prevent automated spam submissions.

What code is in the image?: *

Enter the characters shown in the image.