EL PASO COMMUNITY COLLEGE
Volunteer Application Form
Personal Information
Name:_______________________________________________________
Last First MI
Address:_____________________________________________________
Street # and name or PO Box City State Zip Code
Telephone__________________________ Date of Birth ______________
Month Day Year
Emergency Contact:
___________________________________________________________
Last Name First Name Relationship
Address:______________________________________________________
Street # and name or PO Box City State Zip Code
Telephone_________________________
Work Skills and Experiences
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
Have you identified a Department at El Paso Community in which you would like to
Volunteer ? [ ] Yes [ ] No
If yes, which Department:
___________________________________________________________
_
Why do you wish to contribute your services to El Paso Community College?
____________________________________________________________
____________________________________________________________
___________________________________________________________
_
____________________________________________________________
PF 800-126 (AF) (Rev 08/03)
Reset Form
Print Form
STATEMENT OF RELEASE
I, ________________________________________, fully understand that as a
Printed Name
volunteer at El Paso Community College from ___________ to _______________,
Month / Day / Year Month / Day / Year
I will not be entitled to receive any remuneration from the College; however, I may be
reimbursed expenses incurred on behalf of the College. Further, I accept complete
responsibility for any medical fees that I might incur as a result of injury to me during
this volunteer service and fully release El Paso Community College from any liability for
such injury. I understand that I am not an employee of the College and have no
property interest in employment with the College. During this period of volunteer
service I understand that I will be required to abide by the policies and procedures of the
College.
_____________________________________________________________
_
Signature Social Security Number
____________________________
Date
Supervisor’s Certification
Description of Work:
____________________________________________________________
Volunteer Schedule:________________
Work
Period______________________
Hours/week_______________
Volunteer Site: Department___________________________ Campus ________
____________________________________________________________
_
Supervisor Date
_________________________________________________________________________________
_
Budget Head Date
Volunteer service is : [ ] Approved [ ] Disapproved
_________________________________________________________________________
__
Director of Human Resources Date
PF 800-127 (AF) (Rev 08/03)