VOLUNTEER APPLICATION

DOWNLOAD APPLICATION

PERSONAL INFORMATION

FULL NAME: ___________________________________ DATE: __________________

                     First                              Middle                              Last      

ADDRESS: _____________________________________________________________

                  Street Address                                                                                                  Apt/Suite        

                  _____________________________________________________________

                  City                                                     State                                                      Zip Code        

E-MAIL: __________________________________ PHONE: _____________________

SOCIAL SECURITY NUMBER (SSN): _____-____-_____  

DATE AVAILABLE FOR INTERVIEW: __________________

POSITION APPLIED FOR: _________________________________________________

EMPLOYMENT DESIRED:  FULL-TIME  PART-TIME  SEASONAL

WHAT DAYS ARE YOU AVAILABLE? HOURS ARE 7 PM-2 AM

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

PREVIOUS EMPLOYMENT                             

EMPLOYER 1: __________________________________________________________

                       Company / Individual

E-MAIL: __________________________________ PHONE: _____________________

ADDRESS: ____________________________________________________________

                  Street Address                                                                                                  Apt/Suite        

                  ____________________________________________________________

                  City                                                     State                                                      Zip Code        

JOB TITLE: ______________ RESPONSIBILITIES: _____________________________

FROM: _____________________ TO: _____________________

REASON FOR LEAVING: _______________________________________________________

EMPLOYER 2: __________________________________________________________

                       Company / Individual

E-MAIL: __________________________________ PHONE: _____________________

ADDRESS: ____________________________________________________________

                  Street Address                                                                                                  Apt/Suite        

                  ____________________________________________________________

                  City                                                     State                                                      Zip Code        

JOB TITLE: ______________ RESPONSIBILITIES: _____________________________

FROM: _____________________ TO: _____________________

REASON FOR LEAVING: _______________________________________________________

EMPLOYER 3: __________________________________________________________

                       Company / Individual

E-MAIL: __________________________________ PHONE: _____________________

ADDRESS: ____________________________________________________________

                  Street Address                                                                                                  Apt/Suite        

                  ____________________________________________________________

                  City                                                     State                                                      Zip Code        

JOB TITLE: ______________ RESPONSIBILITIES: _____________________________

FROM: _____________________ TO: _____________________

REASON FOR LEAVING: _______________________________________________________

REFERENCES

(PROFESSIONAL ONLY)                      

FULL NAME: _______________________________ RELATIONSHIP: ______________

                     First                                               Last      

COMPANY: ________________________________ TITLE: ______________

E-MAIL: __________________________________ PHONE: _____________________

FULL NAME: _______________________________ RELATIONSHIP: ______________

                     First                                               Last      

COMPANY: ________________________________ TITLE: ______________

E-MAIL: __________________________________ PHONE: _____________________

FULL NAME: _______________________________ RELATIONSHIP: ______________

                     First                                               Last      

COMPANY: ________________________________ TITLE: ______________

E-MAIL: __________________________________ PHONE: _____________________

BACKGROUND CHECK CONSENT                             

IF ASKED, ARE YOU WILLING TO CONSENT TO A BACKGROUND CHECK? YES  NO

DISCLAIMER                         

Applicant understands that this is a Non-Profit Organization; funds are received through community donations. As a volunteer, you may or may not be compensated for the time invested. An applicant is also committed to excellence through diversity and integrity. In order to ensure this application is acceptable, please print or type with the application being fully completed in order for it to be considered.

Please complete each section EVEN IF you decide to attach a resume.

I, the Applicant, certify that my answers are true and honest to the best of my knowledge. If this application leads to my eventual acceptance, I understand that any false or misleading information in my application or interview may result in my involvement being terminated.

SIGNATURE _________________________________ DATE _____________________

PRINT NAME _________________________________

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