Volunteer Application
Highlight your primary volunteer location*
-- Choose One --
Aitkin, MN
Amery, WI
Apple Valley, MN
Appleton, WI
Arden Hills, MN
Ashland, WI
Askov, MN
Austin, MN
Barrett, MN
Baudette, MN
Bemidji, MN
Bloomington, MN
Brainerd, MN
Butternut, WI
Cameron, WI
Chippewa Falls, WI
Clearbrook, MN
Clintonville, WI
Cook, MN
Cromwell, MN
Cumberland, WI
Dawson, MN
Denmark, WI
Dodgeville, WI
Duluth, MN
East Chain, MN
Eau Claire, WI
Eden Prairie, MN
Ellsworth, WI
Eveleth, MN
Fargo, ND
Fergus Falls, MN
Foley, MN
Fond du Lac, WI
Forest Lake, MN
Gillett, WI
Grand Marais, MN
Grand Rapids, MN
Green Bay, WI - Redeemer
Green Bay, WI-Central
Greenville, WI
Hartford, WI
Hayward, WI
Hermantown, MN
International Falls, MN
Isanti, MN
Jefferson, WI
Ladysmith, WI
Lebanon, WI
Little Falls, MN
Marshfield, WI
Mason City, IA
Medford, WI
Menahga, MN
Mondovi, WI
Montello, WI
Moorhead, MN
Mt. Horeb, WI
New Richmond, WI
North Branch, MN
Onalaska, WI
Onamia, MN
Oshkosh, WI
Osseo, WI
Perham, MN
Peshtigo, WI
Platteville, WI
Prairie du Chien, WI
Ramsey, MN
Redwood Falls, MN
Rhinelander, WI
Rochester, MN
Roseau, MN
Sauk Centre, MN
Sheboygan, WI
Sherburn, MN
Silver Bay, MN
Spooner, WI
St. Charles, MN
Staples, MN
Tomah, WI
Waupaca, WI
Wausau, WI - New Hope
West Bend, WI
Wisconsin Rapids, WI
Zumbrota, MN
Ruby’s Retreat Center - Luck, WI
Ruby’s Well Care Center - Luck, WI
Ruby’s Hair Salon - Luck, WI
First Name*
Middle Name*
Last Name*
Former Last name(s)
Street Address*
City*
Country
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Canada
United States
Zip Code*
Email*
Primary Phone*
Date Of Birth*
Emergency Contact
First & Last Name*
Relationship*
-- Select Relationship
Friend
Family
Father
Mother
Parent
Guardian
Son
Daughter
Child
Aunt
Uncle
Husband
Wife
Partner
Cousin
Grandmother
Grandfather
Grandparent
Grandson
Granddaughter
Grandchild
Employer
Employee
Coworker
Phone Number
Experience & Restriction
Experience / Skill
Medical / Physical Restriction
Background
If yes, please explain:
*Felony conviction does NOT automatically exclude you from participation
If court ordered, please provide nature of the offense:
Hours Required
Group Information
Group Name
Main Contact Person for Group
I agree and WILL NOT hold Ruby’s Heart/Ruby’s Pantry, or their agents or representatives liable for injury or other damages incurred as a result of the job duties given to me as a volunteer. Though thoughtfully assigned, I understand that the final judgment of physical limitations per assignment is solely my responsibility. All food and/or items used for distribution are for donation purposes and/or the property of Ruby’s Pantry and Pop-Up Pantry site.
I grant full permission for Ruby’s Heart/Ruby’s Pantry to use any photographs, film, video or audiotapes of me performing volunteer work for any purpose Ruby’s Heart deems appropriate.
Parent or guardian full name*:
Relationship to applicant*: