Service Site Application : Mercy Volunteer Corps

Organization Information

Name of Organization

Mailing Address

Street Address Address Line 2 City State ZIP Code

Physical Address (if different from above)

Street Address Address Line 2 City State ZIP Code

Phone Number

Website

Site Contact

The person who would manage the relationship with MVC

Name

First Last

Position Title

Phone Number (with extension)

Email Address

Site Supervisor

The person who would supervise the volunteer

Name

First Last

Position Title

Phone Number (with extension)

Email Address

General Information

Desired number of Mercy Volunteer(s):

Organization Information

Has your mission statement, non-profit status, or scope of services changed in the last year? If so, please update in the box below.

The estimated number of people your organization will have served in 2024.

The estimated percentage of the population your organization will have served in 2024 that are below the poverty level.

The estimated number of individuals the Mercy Volunteer(s) will serve during the 2025-2026 service year.

Estimate what your organization would pay a salaried staff member to do the work that you would assign the Mercy Volunteer.

Total Cost Salary and Benefits

Based on these savings, describe what this allows your organization to do.

Financial Information

Has your organization’s funding changed? If yes, please explain. Are any of your new funding sources in direct conflict with the mission of Mercy Volunteer Corps or the values of the Sisters of Mercy of the Americas?

Is funding assured at this time for the $18,000 flat fee financial commitment?

Yes

No+

+If not, at what date will you be certain of a financial commitment?

Insurance

Documentation of Insurance

The volunteer needs to be covered by your organization’s comprehensive and liability insurance for on-site as well as off-site assignments.

Drop files here or

Max. file size: 32 MB.

Volunteer Position Description

Please list the name of the position that you are seeking to fill for the 2025-2026 volunteer year. If you are seeking more than one position, please input the information for the additional position on the following page.*

Site Supervisor*

First Last

Position Title*

Describe the staff structure and size, organization’s facilities and the surrounding neighborhood, and the volunteer’s work space.*

Briefly describe the primary population the volunteer will be serving.*

List the primary responsibilities of this position.*

List the required qualifications for this position (i.e. degree/certification, physical requirements, language, etc.).*

Describe three key skills and/or attributes a volunteer would need in this position.*

What is the work schedule for this position?*

What percentage of time would the volunteer be engaged in direct and indirect service?*

Direct Service (%)

Indirect Service (%)

Please indicate which type of clothing the volunteer would wear at the service site:*

Business casual (slacks, khaki pants, skirt, polo shirt, blouse)

Casual (jeans)

Medical scrubs

Other

If you selected other, please describe the service site dress code.

What type of orientation and initial training would be provided?*

What unique challenges could the Mercy Volunteer encounter in this position?*

Second Volunteer Position Description (optional)

If applying for only one position, please click submit at the bottom of this page.

Site Supervisor

First Last

Position Title

Describe the staff structure and size, organization’s facilities and the surrounding neighborhood, and the volunteer’s work space.

Briefly describe the primary population the volunteer will be serving.

List the primary responsibilities of this position.

List the required qualifications for this position (i.e. degree/certification, physical requirements, language, etc.).

Describe three key skills and/or attributes a volunteer would need in this position.

What is the work schedule for this position?

What percentage of time would the volunteer be engaged in direct and indirect service?

Direct Service (%)

Indirect Service (%)

Please indicate which type of clothing the volunteer would wear at the service site:

Business casual (slacks, khaki pants, skirt, polo shirt, blouse)

Casual (jeans)

Medical scrubs

Other

If you selected other, please describe the service site dress code.

What type of orientation and initial training would be provided?

What unique challenges could the Mercy Volunteer encounter in this position?

Email

This field is for validation purposes and should be left unchanged.

Service Site Application

Service Site Renewal Application

Organization Information

Site Contact

Site Supervisor

General Information

Organization Information

Estimate what your organization would pay a salaried staff member to do the work that you would assign the Mercy Volunteer.

Financial Information

Insurance

Volunteer Position Description

Second Volunteer Position Description (optional)

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