Contact Information

Name

Street Address

City ST ZIP

Home Phone

Cell Phone

E-Mail Address

Availability

During which hours are you available for volunteer assignments?

Monday –

Thursday –

Tuesday –

Friday –

Wednesday –

Saturday–                    

Sunday –

Interests

Tell us in which areas you are interested in volunteering

__ Administrative/Clerical

__ Cleaning/maintenance

__ Events/Exhibits

__ Marketing

__ Deliveries

__ Art Workshops

__ Tours of the Lake Mansion

__ Historic Research

__ Presentations in the community

__ Other

Special Skills or Qualifications

Summarize special skills and qualifications (i.e. hands-on, clerical, computer skills, maintenance, part of a committee, marketing) you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.

Previous Volunteer Experience

Summarize your previous volunteer experience. Include whether or not you are volunteering through an organization/school. (United Way, UNR, community service requirement, etc.)

Person to Notify in Case of Emergency

Name

Street Address

City ST ZIP Code

Home Phone

Work Phone

E-Mail Address

Agreement and Signature

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that 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.

Name (printed)

Signature

Date

Our Policy

It is the policy of this organization 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.