Volunteer Application
Volunteer Application For Embracing Abilities Inc.
Volunteers must be 14 or older. Do you meet this requirement?
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Please Select
Yes
No
Name
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First Name
Middle Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Please enter a valid phone number.
Email
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example@example.com
Please select the last grade completed. (High School/College)
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9th
1
10th
2
11th
3
12th
4
How did you hear about Embracing Abilities?
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What interested you about this volunteer position?
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What are your personal goals for this experience?
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Do you have experience working with children or adults with special health care needs? If so please describe.
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What would you like to know about our program?
Health: (Describe any limitations which could interfere with your performance):
Areas of Interest
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Administrative/Clerical
Music
Technology
Arts/Crafts
Sports
Customer Service
Availability-- Please list all avaliable days.
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Monday
Tuesday
Wednesday
Thursday
Friday
Please list 3 references below. Please list name, phone, email and relationship. *Please provide references that are not related to you.
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I authorize my references to provide information to Embracing Abilities that is relevant to myvolunteerism.
If selected, when can you begin?
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Have you been convicted of a Misdemeanor or Felony?
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Please Select
Yes
No
Note: Conviction means you were found guilty by a judge, jury, “no contest” or guilty plea in court. A conviction may have taken place even if you did not pay a fine or spend any time in jail or prison. A conviction will not automatically disqualify you from volunteer placement. Embracing Abilities will determine which convictions disqualify volunteer placement. Any misrepresentation will disqualify you from a volunteer position.
STATEMENT OF COMMITMENT: I certify that the information in this application are true and correct, and have been given voluntarily. If accepted as a volunteer I will fulfill my commitment of service and maintain annual educational and health testing requirements. I agree to respect the dignity and rights of each individual in the strictest of confidence. I understand that violations of any of the policies of Embracing Abilities may result in my immediate dismissal from the volunteer program. I understand and give my permission to release any and all information from your files as permitted by law pertaining to criminal history.
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Submit
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