STUDENT VOLUNTEER PROGRAM
INFORMATION SHEET AND AGREEMENT
TO BE COMPLETED BY VOLUNTEER
Name:
Address:
City:
State:
Home Phone:
Cell Phone:
Email Address:
School:
Major:
GPA:
What type of career exposure would you like to gain?
What location(s) are you interested in volunteering?
1
st
choice 2
nd
choice
How many hours are you willing to volunteer each week?
Are you related by blood or marriage to any person now working for NCDOT?
Yes No
If yes, give name, relationship to you and the office where employed.
I understand that I am applying to a volunteer program and although I may benefit both personally
and professionally from this experience, I will not receive nor expect any compensation from
NCDOT for my service as a student volunteer. I am willing to perform the volunteer service
without promise, expectations, or receipt of wages and without any coercion or pressure from
NCDOT.
Signature
Please attach a copy of your unofficial transcript
click to sign
signature
click to edit
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