Volunteer Application

Volunteer Application

Volunteer Application
Applicant Information:
Name:*

First NameMiddle NameLast Name
Date:*

MonthDayYear
Date
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:*
Please enter a valid phone number.
Email:*
example@example.com
SSN:*
Driver License #*
Please add the state of DL
YesNo
YesNo
YesNo
If yes, explain:
EOCWeather WatchPatrol

Education Information:
High School:*
Years Attended:*
YesNo
Degree:
College:*
Years Attended:*
YesNo
Degree:
Other:
Years Attended:
YesNo
Degree:

Employment Information:
(Last two employers)
Company:*
Phone Number*
Please enter a valid phone number.
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Job Title:*
Supervisor:*
Responsibilities:*
Years Worked:*
Starting Year to Ending Year
YesNo
Reason for Leaving:*
Company:*
Phone Number*
Please enter a valid phone number.
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Job Title:*
Supervisor:*
Responsibilities:*
Years Worked:*
Starting Year to Ending Year
YesNo
Reason for Leaving:*

References:
(Please list three references)
Reference #1*
Reference #2*
Reference #3*

Military Service:
Branch:
Years Served:
Rank at Discharge:
Type of Discharge:
If other than honorable, explain:
Disclaimer and Signature:
- I certify that my answers are true and complete to the best of my knowledge.
- I authorize Moore County to conduct a complete background check, including criminal history.
- If this application leads to acceptance into the program, I understand that false or misleading information in my application or interview may result in my release from the program.
Type a question*
To complete this form, a copy of your driver's license and proof of acceptable automobile insurance, must be uploaded below:
File Upload*

Cancelof
Should be Empty: