Volunteer Application

First Name*

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Last Name*

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Phone Number*

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Email Address*

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Street Address*

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City*

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State*

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Zip Code*

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Emergency Contact Name*

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Emergency Contact Phone*

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Past Volunteer Experience*

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Employment*

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Desired Schedule (check days and times available)*

Monday-Friday morning (9am to noon)

Tuesday-Saturday afternoon (noon to 2:30pm)

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Why do you want to volunteer with this organization?*

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How would you like to help this organization?*

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Education/Credentials

If over 18 years old, start with high school.

School*

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Date*

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Degree*

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Location*

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School

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Date

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Degree

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Location

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References

Give the name, address, and phone/email of three non-family members who can provide references on your ability to perform this volunteer position.

Reference Name*

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Address*

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Phone Number*

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Reference Name*

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Address*

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Phone Number*

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Reference Name*

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Address*

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Phone Number*

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I hereby allow ARVAC to perform a check of my background, including:*

Criminal Record

Driving Record

Employment Verification

Volunteer History

Education/Diploma Verification

Personal References and other persons or sources as appropriate for the volunteer job in which I have expressed interest

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I understand that I do not have to agree to this background check, but refusal to do so may exclude me from consideration for some types of volunteer positions and that all such information collected during the check will be kept confidential.

I hereby also extend my permission to those individuals or organizations contacted for the purpose of this background check to give their full and honest evaluation of my suitability for the described volunteer work and other such information, as they deem appropriate.

Applicant Signature*

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Today's Date*

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