Volunteer/School Community Service Application

Volunteer/ School Community Service Application

Application is for volunteers and academic community service requirements only
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Date of Birth*

MonthDayYear
Date
Age*
Race? (select all that apply)*

AsianAmerican Indian or Alaska NativeBlack or African AmericanNative Hawaiian and Pacific IslanderWhitePrefer not to say
Ethnicity?*

Hispanic/LatinoNot Hispanic/LatinoPrefer not to say
School if applicable
Grade level if applicable
School information (degree you are seeking, school contact information such as name, email, phone number, and any other relevant information)
If capacity is available, tell us a little bit about you. What would you wish to learn from this opportunity? What do you see yourself doing within our programs? what skills or contributions will you be bringing?
Emergency Contact:
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relationship:*
Availability
Date you are available to start?*

MonthDayYear
Date
Days of the week*

MondayTuesdayWednesdayThursdayFriday
Time of the week*

9am10am11am12pm1pm2pm3pm4pm5pm6pm7pm
Community Service Information

Your court papers are required in order for you to start your community service with us.
How many hours of community service do you have to complete?*
By what date do you need to complete your community service*

MonthDayYear
Date
How did you hear about us?*

Family or FriendSchoolOnline searchSocial mediaOther
Agreement

I verify that the information given in this application is correct and I authorize the Corazón Community Services staff to contact my school, court or other entity that is responsible for verifying your hours. I understand that my community services will vary in talks and will be asked by staff to do certain duties. The use of cell phones during your scheduled hours of community services is allowed only for emergency. I understand that I will be given a letter if requested based on the total amount of hours completed. Individuals will track and fill out hour entries and signed of by a Corazón Community Services staff. Failure to comply may result in not being able to finish hours at Corazón Community Services.
Signature*

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Volunteer/ School Community Service Application

Emergency Contact:

Availability

Community Service Information

Agreement