Volunteer Application

First Name

Your Last Name

Address

City

State

Zipcode

Phone

Email

Are you 18 or older?

Yes No

Do you have active health insurance?

Yes No

Have you been convicted of a crime in the past 7 years?

Yes No

If you have been convicted, please list the nature of the offence.

Highest Education Level

Are you currently in school?

Yes No

If yes, please list the name of the school.

Are you currently employed?

Please list your job title, name of current employer, and tell us a little about your current job description.

Please list previous work experience.

Why do you want to volunteer for us?

Please list previous volunteer experience.

What skills do you have that might be useful to us?

Have you volunteered with us in the past?

Yes No

Have you ever applied to volunteer with us?

Yes No

Please list any other experience or info that you think is important.