VOLUNTEER APPLICATION FORM

VOLUNTEER APPLICATION FORM
Please fill out the form completely.

WE RESERVE THE RIGHT TO REFUSE AN APPLICANT.
Name:
Email Address:
example@example.com
Address

Home Address

Street Address Line 2

City, State ZipState / Province

Postal / Zip Code
Employed By (If Employed):
Address:
Phone Number:
Brief description of work:
Education:
Major
Degree
Other Schooling or Special Training
Interests or Hobbies
Would you be interested in helping with: (check all that apply)
Can you help with education efforts by:
Can you help with advertising by: (check all that apply)
Skills (be specific. i.e. database knowledge, marketing, videography, photography, catering, etc.)
Do you speak a foreign language?
If yes, which language
Do you drive?
Do you have regular access to a car?
Current community activities:
Are you willing to commit to one year of volunteer services? (If no, this will not disqualify you from consideration.)
List current and previous volunteer work (list all previous volunteer work including brief description of duties and activities, dates of service:
What are your reasons for wanting to volunteer with Tempo!?
Have you had any personal experience(s) involving individuals with diverse needs?
If yes, please explain:
How did you learn of our program?
Have you ever been convicted of a crime other than a traffic violation?
If yes, what charge?
Date convicted:
Date convicted:

MonthDayYear
Date
Where
Sun.
Mon
Sat.
Mornings:
Afternoons:
Evenings:
Which location?
Who or what prompted you to volunteer?
Please list three references of people who know you well, other than relatives, preferably for whom you have worked in either a paid or volunteer capacity. If you are currently working, either paid or as a volunteer, please include the name of your supervisor.

Name Address Phone
Tempo! reserves the right to make any checks deemed appropriate as to the suitability of anyone responsible for this confidential work. All information obtained will be held in the strictest confidence.

By signing this application, I declare that all of the above information I have given is true and complete.
Applicant Signature
Date

MonthDayYear
Date
Should be Empty: