Volunteer Application

The Early Literacy Program Volunteer Application

Please fill out this form

General Information

NameFirstLast

ResidenceStreet AddressAddress Line 2CityState / ProvinceZip / Postal CodeCountry

Email:

Phone Number - (###) - #######

Date of Birth

Social Security Number:

Do you have your own transportaion?yesno

Have you ever been convicted of a felony?yesno

Availability

Months available to commit to volunteer for:

Hours per week:

Please check days of the week you are available to volunteer:MonTueWedThurFriSatSun

Interest

Please check the areas in which you are interested in volunteering (check all that apply):ReadingSpecial EventsBook DrivesFund Raising

Is there a specific program site you are interested in supporting?

Special Skills or Qualifications

Summerize any special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities including hobbies or sports:

Refrences

Please provide 2-3 references that we could contact to get a better understanding of who you are and what you would bring to our organization.

R-1FirstLast

R-1 infoStreet AddressAddress Line 2CityState / ProvinceZip / Postal CodeCountry

Telephone 1 - (###) - #######

R-2FirstLast

R-2 infoStreet AddressAddress Line 2CityState / ProvinceZip / Postal CodeCountry

Telephone 2 - (###) - #######

R-3FirstLast

R-3 infoStreet AddressAddress Line 2CityState / ProvinceZip / Postal CodeCountry

Telephone 3 - (###) - #######