2025 Volunteer Application

Name

Address

Phone

Community Service Information

(If you are applying to complete community service hours, complete this section)

Referring Agency

Contact Person

Phone Number

Charges (if any)

School Contact Information

(If you are applying for an internship position, complete this section)

Referring School

Contact Name

Address

Phone

Availability

Volunteers are permitted from 8a.m. - 8p.m.

Choose Volunteer Location

Areas of Interest

Tell us more about how you'd like to get involved. Offering a workshop, a weekly class, or good at handy work? Tell us here.

Start Date:

End Date:

Hours Available Per Week

Reference Information

Reference #1 Name

Address

Phone

Reference # 2 Name

Address

Phone

Address Phone Layout

Reference # 3 Name

Address

Phone

Emergency Contact Information

Name

Address

Phone

Alt Phone

Agreement and Signature

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted for community service, as an intern or volunteer, any false statements, omissions or other misrepresentations made by me on this application may result in my immediate dismissal. Also, by signing, I am this application; I am providing consent for all references to be contacted.

Signature

Date

Community Service Information

School Contact Information

Availability

Reference Information

Emergency Contact Information

Agreement and Signature

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