Volunteer Candidate Registration Form

Volunteer Application
Personal Information
Name*

First NameLast Name
Deaf Status*
Pronouns:*
If your pronouns weren't listed above, please expand below:
*As well as any details about your gender identity you'd like us to know :)
Birth Date*

MonthDayYear
Phone*
E-mail*
example@example.com
VP Phone
Please enter a valid phone number.
Emergency Contact*

NameRelationship
Phone*
Emergency Contact phone number.

References

Provide contact information for two people who have known you for more than two years. *Not including relatives or roommates.
Reference No.1*

NameRelationship
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Reference No.2*

NameRelationship
Phone Number*
Please enter a valid phone number.
Email*
example@example.com

Volunteer Release of Information

*Please read the following carefully!!!
Application Information

I certify that all information in this application is true and complete.

I understand that any false information or omission may disqualify me from further consideration for volunteer service and may result in my dismissal, if discovered, at a later date.

References

I understand that DWAVE requires information from me to evaluate my qualifications for volunteer service.

I authorize and release personal references, employers (past and present), and, if necessary, other applicable entities to answer questions in regards to volunteer work, employment, ability, and character.

I understand the requested information is for the sole purpose of gathering accurate information for volunteer services for DWAVE.
I blanks* have read and understand the information above and by my signature consent to these statements. Signature*
Should be Empty:

Volunteer Application