Volunteer Application

Contact Information
Name *
Name
Address *
Address
Day Phone *
Day Phone
Evening Phone
Evening Phone
Residence Information
Are you a seasonal resident? *
If yes, Out of Town Address
If yes, Out of Town Address
Phone
Phone
Background
Have you ever been arrested? *
Have you ever been convicted of any crime? *
Are there any charges pending against you at this time? *
Are you restricted by law or court decree from being in the vicinity of children? *
Education
High School
College
Other
Are you currently enrolled as a student? *
In the event of an emergency, indicate that you will authorize the above information may be shared. *
Employment
Are you currently employed? *
Volunteer Service
Do you currently volunteer anywhere? *
Have you volunteered in the past? *
Related Experience
Do you speak another language other than English? *
Availability
What day or days would you be available? *
Which would you prefer? *
Areas of Interest
Review the Volunteer Opportunities below and choose three areas of service which interest you. *
Emergency Contact Information
Volunteer Name *
Volunteer Name
Emergency Contact Name *
Emergency Contact Name
Phone *
Phone
Cell Phone
Cell Phone
Address *
Address
Physician Information
Phone *
Phone
Allergies
Health Issues
Authorization
In the event of an emergency, indicate that you authorize the above information may be shared. *
By checking the following, you are indicating that the above information is correct to the best of your knowledge. *