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Volunteer Application

Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Birth Date
MM slash DD slash YYYY
Are volunteer hours a requirement for school?
- Yes
- No
Name of school:
Are volunteer hours a requirement to complete a program?
- Yes
- No
Name of program:
How many hours are required for completion?
Have you ever been convicted of a crime? [If yes, please explain the nature of the crime and the date of the conviction and disposition.] Conviction of a crime is not an automatic disqualification for volunteer work.
Skill/Work Experience
Past Volunteer Experience
I am interested in the following volunteer positions available:
- School Age Learning Center Volunteer Assistant (If 18 years of age or older clearances will be necessary)
- Junior Camp Counselor (ages 13-17)
- Safe Home Volunteer (training provided and clearances required)
- Girls Loving Life Volunteer (clearances required)
- Early Learning Center Reading Volunteer (clearances required)
- Photographer/Videographer
I would like more information on available committee openings:
- Finance Committee
- Personnel Committee Facility/Safety Committee
- Fund Development Committee
- Advocacy Committee
Availability (choose all that apply)
- Eveinings
- Weekends
- Mornings
- Afternoons
Availability Part 2 (choose all that apply)
- Weekly
- Bi-weekly
- Monthly
- To be determined
Hobbies, Skills, or Talents to share?
Special interests?
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23 W. Chestnut St. Hanover, PA 17331 | Phone: (717) 637-2125 | Fax: (717) 637-3516

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