Volunteer Application Form

Name

Date

Cell Phone

Work Phone

May we contact?

Address

City

State

Zip

Emergency Contact Name

Emergency Contact Phone

How did you hear about the volunteer opportunities at First Light?

There are many volunteer opportunities at First Light, so please tell us what you are expecting from your volunteer experience here and what you believe your strengths or talents are:

Why are you interested in volunteering for First Light Child Advocacy Center?

What days and hours are you available to volunteer?

Have you volunteered here before?

Do you have a valid driver's license?

Do you have a reliable vehicle?

Insurance Company

Policy Number

Position Held

Organization

Start Date

End Date

Address

City

State

Zip

Phone

Supervisor

May we contact?

Reason for Leaving

Position Held

Organization

Start Date

End Date

Address

City

State

Zip

Phone

Supervisor

May we contact?

Reason for Leaving

Position Held

Organization

Start Date

End Date

Address

City

State

Zip

Phone

Supervisor

May we contact?

Reason for Leaving

School

Number of Years Completed

Degree / Diploma

Major

School

Number of Years Completed

Degree / Diploma

Major

School

Number of Years Completed

Degree / Diploma

Major

Please list people who you have known for at least 2 years, not including relatives.

Name

Relationship

Years Known

Phone

Address

City

State

Zip

Name

Relationship

Years Known

Phone

Address

City

State

Zip

Name

Relationship

Years Known

Phone

Address

City

State

Zip

I acknowledge the confidentiality statement.

I consent to a criminal background check.

Date of Birth

Social Security Number

I hereby affirm that all the answers on this volunteer application are true to the best of my knowledge.

Signature (Type full name)

Signed Date