| Volunteer Application |
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 1) First and Last Name |
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2) Gender |
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3) Birthday (Month/Day/Year) |
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4) Address (street #, street name, city, state, zip code) |
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5) Phone number |
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6) Ethnicity/Language |
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7) Email |
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8) Emergency contact (Name, relationship, and phone number) |
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9) List work-related skills, training, and interests |
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10) List any special needs/restrictions on volunteer/intern activities |
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11) Are you completing hours for a specific requirement? If yes, please state the number of hours, purpose of the requirement, and the time frame you have to finish your hours by. |
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12) Who may we contact regarding your service requirement? (Name and phone # or email) |
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13) What would you like to do as a volunteer? |
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14) Indicate when you would like to volunteer (day and time) |
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15) How did you hear about us? |
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16) I do hereby declare that all information given and statements made herein and in conjunction with this application is true; and if accepted, any information discovered to be false is grounds for termination. I also consent to have all information checked and give my permission to any and all persons contacted to release any related information requested in connection with this volunteer application, and I agree not to hold any such person or company liable for the information that they give out. |
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17) What do you hope to learn, experience, and or achieve while and after volunteering? Please be very specific to help us prepare volunteering opportunity that best fits your needs. |
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