200 Dent Street
Rocky Mount, VA 24151
(540) 483-5142
 

Volunteer Application

Volunteer Position Sought: *
Date *
Last Name: *
First Name:*
M.I.
E-mail *
Primary Phone *
Primary Phone Type: *
Alternate Phone
Street Address *
Apartment/Unit #
City *
State *
Zip *

Education

* Did you graduate high school or do you have a high school equivalency diploma?
(If No:) Highest Grade completed?
Number of years of post-high school education:

Employment

Current Employer, if applicable:

Employment #1

Employment #2

Employment #3

Employment #4

Employment #5

Employment #6

Other

SKILLS & EXPERIENCE

Special training, skills, hobbies:*
Groups, clubs, organizational memberships:*
Please describe your prior volunteer experience (include organization names and dates of service)*
What experiences have you had that may prepare you to work as a volunteer in the field of human services?*
Why do you want to volunteer?*

* Do you have a driver’s license?

References

List names, addresses, and relationships of three persons not related to you who know your professional qualifications. (These references are not a substitute for work related references.)

Name/Organization *
Relationship *
Length of Relationship *
Phone *
Name/Organization *
Relationship *
Length of Relationship *
Phone *
Name/Organization *
Relationship *
Length of Relationship *
Phone *


 
Please read the following carefully before signing this application:
I understand that this is an application for and not a commitment or promise of volunteer opportunity. I certify that I have and will provide information throughout the selection process, including on this application for a volunteer position and in interviews with STEP, inc. that is true, correct and complete to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and that I have not and will not withhold any information that would unfavorably affect my application for a volunteer position. I understand that information contained on my application will be verified by STEP, Inc. I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant for a volunteer position with STEP, Inc. or my termination as a volunteer.
Applicant Signature *
Date: *