Resident Application

Name*
First Last
Email*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Birth Date*
MM slash DD slash YYYY
What are your four letters from the Meyers-Briggs personality test?*
ex: INFP
Do you have a high school diploma or GED?*
- Yes
- No
Do you have a driver's license?*
- Yes
- No
Are you employed?*
- Yes
- No
Are you pregnant?*
- Yes
- No
If you could do anything with your life what would it be?
Please share your dreams no matter how big or silly or out of reach they may seem right now. Tell us about the real you, not the one others or even you think you should be, the one you truly are. Because the more we know you the better we can help.
Which of the following events are you excited to be part of if chosen for Be the Magic?
- Fun Run
- Cook Out
- Themed Dance Party
- Craft Fair
- Elderly Visits
- Meditation
- Yoga
- Movie Night
- Speakers
- Pizza Party
You will be required to have a part time job while residing at Be the Magic. Which shift do you prefer working?*
- First
- Second
- Third
Where did you hear about Be the Magic?
- Email
- Website
- Friend
- Online Search
- Other
Personal Bio*
Briefly tell us about yourself. Include what you expect to gain by being part of Be the Magic.
Health Restrictions*
Please note any health conditions, physical limitations, and or medications you are currently taking.
Reference #1*
Please list two references. If you don't have two, provide at least one. For example, a caseworker, an employer, a teacher, a friend, a counselor, etc.
First Last
Reference #1 Email
Reference #1 Phone
Reference #1 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Reference #2
Please list two references. If you don't have two, provide at least one. For example, a caseworker, an employer, a teacher, a friend, a counselor, etc.
First Last
Reference #2 Email
Reference #2 Phone
Reference #2 Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Volunteer/Client Association*
Are you acquainted with, or related to, any of our current or past volunteers or clients?
- Yes
- No
Acquaintance Name*
First Last
How are you acquainted?*
Do you have an additional acquaintance?
- Yes
- No
Second Acquaintance Name*
First Last
How are you acquainted?*
Publicity Consent*
May we use your name and/or likeness (photo) in publicity related to Be the Magic?
- Yes
- No
Consent*
I agree to the terms
Submission of this application will be treated as a signature to the following statement: I understand that an incomplete application may exclude me from consideration. I certify that the answers provided are true and complete to the best of my knowledge. I also authorize investigation of all statements contained in this application. I further understand that Be the Magic WILL conduct a background check on me and that I do consent to this. I understand that Be the Magic is not obligated to accept me into their volunteer program and that if accepted they or I may terminate the volunteer agreement at any time. If accepted, I understand that false or misleading information given in my application(s) or interview(s) may result in discharge at any time. I agree to treat all information I may hear, see, read, or otherwise acquire highly confidential and I will not reveal or discuss this information outside of my official duties at Be the Magic.
Handbook*
I have read the resident handbook
Are you under the age of 18?*
- Yes
- No
Name of Parent or Guardian*
First Last
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Contact Us

125 South John Street, Neenah WI, USA 54956

[email protected]

+1 (920) 460-6932