Volunteer Application

Please print

First Name: *

Last Name: *

Address *

Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Phone #: *

Email *

Reason for Volunteering:

ChurchSchool / InternshipService Club (Boys / Girls Scouts, etc.)Other

Please select correct response:

Physical Limitations:

NoYes

List previous volunteer experience:

Special Skills or Qualifications

Summarize skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies and sports.

Interests *

Tell us in which areas are you interested in volunteering.EventsFundraisingOpportunities CenterYouth Community Enrichment ProgramAdult Community Enrichment ProgramTransportation

Volunteer availability: (Select all applicable) *

Number of Days per week:12345

Day per Week: *

MondayTuesdayWednesdayThursdayFridaySaturdaySundayNo Preference

Time of day: *

MorningsAfternoonsEvenings

In an Emergency, notify:

First Name *

Last Name *

Phone #: *

Address *

Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

By submitting this agreement, I affirm that the facts set for the in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application my result in my immediate dismissal.

Signature: *

Date *

Comments:

In order to be eligible to volunteer at The Arc, you must be able to satisfactorily pass a criminal background check. The following information will be used exclusively for that purpose.

The Arc Fond du Lac

CONTACT INFORMATION

PERSONAL INFORMATION

EMERGENCY CONTACT

AGREEMENT AND SIGNATURE

Criminal Background Check

Verification