Fillable CITYOFDULUTH VOLUNTEERAPPLICATION TitleofVolunteerOpportunity FirstName LastName Organization #ofMembers and/orGroup (City of Duluth)

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CITYOFDULUTH VOLUNTEERAPPLICATION TitleofVolunteerOpportunity FirstName LastName Organization #ofMembers and/orGroup (City of Duluth)

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CITYOFDULUTH

VOLUNTEERAPPLICATION

ReturncompletedVolunteerApplicationtoCherylSkafte,VolunteerCoordinator,atcskafte@duluthmn.govorbymailateither

DuluthPublicLibrary|520WSuperiorSt,Duluth,MN55802orCityHallParksDepartment|411W1

Street,Duluth,MN55802

Thankyouforyourinterestinvolunteeringwiththe

CityofDuluth.Pleasefillouttheapplicationand

returntoCherylSkafteatcskafte@duluthmn.govor

bymailat411W1

Street,Duluth,MN55802.

TitleofVolunteerOpportunity

Ifnotapplyingforaspecificvolunteerposition,pleaseleaveblank.



FirstName LastName

Organization

and/orGroup

 #ofMembers

PrimaryPhone Email

StreetAddress City,StateZip

Areyou18yearsoldorolder? YESNO

Filloutthissectiononlyifapplicantis

under18yearsold.Pleasenoteifyou

are15yearsoldoryounger,youwill

needtovolunteerwithanadult.

Parent/GuardianName

Parent/GuardianPrimaryPhone

Parent/GuardianSignature

VOLUNTEERINTERESTS:Checkthetypesofopportunitiesyou’reinterestedinreceivinginformationabout.



 CommunityEducation/Outreach

 InvasiveSpeciesRemoval

 ParkBeautification

 TreePlanting/Maintenance

 Landscaping/Gardening

 SpecialEvents

 YouthSportsCoach

 YouthDevelopment

 RecreationActivities

 TrailMaintenance



Whyareyouinterestedinvolunteering

withParksandRecreation:







Listanyskills,trainingorexperienceyouwouldbringtothisvolunteeropportunity:



Describeyourinvolvementincommunityactivitiesorothervolunteerwork(organization,activity,dates

ofservice):



(Over)

CITYOFDULUTH

VOLUNTEERAPPLICATION

ReturncompletedVolunteerApplicationtoCherylSkafte,VolunteerCoordinator,atcskafte@duluthmn.govorbymailateither

DuluthPublicLibrary|520WSuperiorSt,Duluth,MN55802orCityHallParksDepartment|411W1

Street,Duluth,MN55802

Thankyouforyourinterestinvolunteeringwiththe

CityofDuluth.Pleasefillouttheapplicationand

returntoCherylSkafteatcskafte@duluthmn.govor

bymailat411W1

Street,Duluth,MN55802.

Whenareyouavailable?Pleaseindicateallavailablehours.Aregularschedulewillbeestablishedupon

selection.Checkatleastoneoption:

 Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Morning    

Afternoon    

Evening    



Haveyoueverbeenconvictedofacrime? ___Yes ___No



Ifyes,andoverage18,provideshortexplanationoutliningthecircumstancesofyourconvictionincluding

date,natureandplaceofoffense,anddisposition.(Donotincludetrafficviolationsorconvictionssealed,

expunged,orannulledbythecourt.Convictionswillnotnecessarilydisqualifyyoufromvolunteering.)



Somepositionsmayrequireuseofyourownvehicle.Canyouprovideyourowntransportation?

 ___Yes ___No



Adrivingrecordcheckwillbenecessaryifyourvolunteeropportunityrequiresdriving.



Providetwopersonalreferencesfamiliarwithyourskills,experience,orcommunityactivitieswhomwe

maycontact.Listnameandphonenumber.



1.ReferenceName  Phone

  Email:

2.ReferenceName Phone

  Email:



IherebycertifythatIhaveansweredtruthfullyandhave notknowinglywithheldanyinformationrelativeto myapplication.Iagree

andunderstandthatanymisstatementsormaterialomissionsontheapplicationwillresultinmybeingeliminatedfromfurther

consideration.Iunderstandthat,ifaccepted,anymisrepresentationormaterialomission

whichbecomesknowntotheCityof

Duluthmayresultinmyimmediatedismissal.





Signature(Pleasetypenameissubmittingelectronically)   Date



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Completed 3 August 2020

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