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

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