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2. Volunteer Services Application Form
   Thank you for your interest in volunteering your time and talent! Knowing a little bit about you will help us identify the most appropriate and comfortable volunteer experience for you, so please fill this out as completely and accurately as possible.
4. Full Name (Last, First MI):*
5. Date of Birth:*
   Date of Birth:
7. Street Address:
9. City:
10. State:
11. Zip Code:
13. Home Phone:
14. Cell Phone:*
15. Email Address:*
17. Major / Education Background:
19. Please list the name and phone number of one personal reference:
21. Name:
22. Phone Number:
24. Reason for Volunteering:*

    1. College Service Learning Requirement
    2. College Volunteer
    3. Community Group

    1. Court Ordered Community Service
    2. Encouraged/Required by Employer
    3. Individual
26. List Group Name, Course Title, Professor/Instructor, or Employment Agency from question if checked above:
28. Service Interests:*

    1. Community Event
    2. Environment
    3. Family

    1. Older Adults
    2. Youth
    3. Other / Specific Program
30. If Other / Specific Program was checked, please list:
32. Skills: Please list specific skills you have (i.e. hobbies, interests, certifications, etc.):
34. If you must complete your volunteer hours during a specific time frame, please indicate:
36. If applicable for program, what is your availability:
38. Please note specific programs may not be flexible on days/times that volunteers can assist. For example, those who commit to coach youth sports must coach on advertised nights of the youth sport.
40. Mondays
41. Tuesdays
42. Wednesdays
43. Thursdays
45. Fridays
46. Saturdays
47. Sundays

49. If you have completed our background check within the last nine (9) months, you do not need to submit it again.  You will need to complete it again if it has been over nine (9) months since your last background check with us.

Leave This Blank:


51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit

* indicates a required field