Fillable City of Hopewell Office on Youth Volunteer Application (CITY OF HOPEWELL)

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City of Hopewell Office on Youth Volunteer Application (CITY OF HOPEWELL)

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The City of Hopewell Office on Youth Volunteer Application (CITY OF HOPEWELL) form is 2 pages long and contains:

  • 1 signature
  • 9 check-boxes
  • 50 other fields

Country of origin: US
File type: PDF

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City of Hopewell Office on Youth
Volunteer Application
Contact Information
Name
Street Address
City ST ZIP Code
Phone
E-Mail Address
General Information
Gender
□ Male
□
Female
Date of Birth ___ / ___ /___
Occupation
Employer
Does your employer encourage you to volunteer, provide you with volunteer hours/days, and/or match
volunteer hours? _______ Yes _______ No
Availability
During which hours are you available for volunteer assignments? Please select all that apply.
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Morning
Afternoon
Evening
How often would you like to volunteer?
___ 2-3 week ___ once a week ___ once a month ___ special events
Are you volunteering to fulfill community service hours for school or a court order? ____ Yes or ____ No
If yes, please share how many hours are required __________________
Interests
Tell us in which areas you are interested in volunteering
___ Administration
___ Communication (Newsletter, Social Media, etc.)
___ Direct program support (Mentoring, Tutoring, etc.)
___ Research
___ Special Events
___ Volunteer coordination
___ Other: ___________________
______________________________________________________
Special Skills or Qualifications
Briefly summarize special skills and qualifications you have acquired from employment, previous
volunteer work, or through other activities, including hobbies or sports.
Previous Volunteer Experience
Briefly summarize your previous volunteer experience.
Person to Notify in Case of Emergency
Name
Phone
Relationship
Agreement and Signature
By submitting this application, I affirm the facts set forth in it are true and complete. I understand if I am
accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on
this application may result in my immediate dismissal.
I understand in order to work directly with youth, I must submit to and pass a criminal background check.
Name (printed)
Signature
Date
Our Policy
It is the policy of the Office on Youth to provide equal opportunities without regard to race, color, religion,
national origin, gender, sexual preference, age, or disability.
Thank you for completing this application form and for your interest in volunteering with us.
Please complete this application and 1) submit electronically, 2) email to Sebanks@hopewellva.gov
or 3)
mail to: Office on Youth, 300 N Main Street, Suite 216, Hopewell, VA 23860
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City of Hopewell Office on Youth Volunteer Application (CITY OF HOPEWELL)

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Completed 3 August 2020

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