Volunteer Application

Volunteer Application

Please fill out and submit or download a hard copy.
Full Name *

First Name Middle Name Last Name
Current Address *

Street Address

Street Address Line 2

City State

Zip Code
Email Address *
Phone Number

Area Code Phone Number
Position Applied for:

EOC Weather Watch Patrol
Are you a citizen of the United States

Yes No
If no, Are you authorized to work in the U.S.?

Yes No
Have you ever been convicted of a felony?

Yes No
If yes, explain:
Education
High School
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
From

Month Day Year
To

Month Day Year
Did you graduate?

Yes No
College
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Did you graduate?

Yes No
From

Month Day Year
To

Month Day Year
Other
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Did you graduate?

Yes No
From

Month Day Year
To

Month Day Year
References

Please list three references
Name

First Name Last Name
Relationship
Company
Phone Number

Area Code Phone Number
Name

First Name Last Name
Relationship
Company
Phone Number

Area Code Phone Number
Name

First Name Last Name
Company
Phone Number

Area Code Phone Number
Employment
Company
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number

Area Code Phone Number
Supervisor

First Name Last Name
Job Title
Responsibilites
From

Month Day Year
To

Month Day Year
Reason for Leaving
May we contact your supervisor for a reference?

Yes No
Company
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number

Area Code Phone Number
Supervisor

First Name Last Name
Job Title
Responsibilities
From

Month Day Year
To

Month Day Year
Reason for Leaving
May we contact your previous supervisor for a reference?

Yes No
Company
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number

Area Code Phone Number
Supervisor

First Name Last Name
Job Title
Responsibilities
From

Month Day Year
To

Month Day Year
Reason for Leaving
May we contact your previous supervisor for a reference?

Yes NO
Military Service
Branch
From

Month Day Year
To

Month Day Year
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 a 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.
Enter the message as it's shown *
Digital Signature
You must submit with this application the following:

Copy of your Texas Driver's License Proof of current acceptable automobile insurance
Driver's License
Acceptable Automobile insurance
Should be Empty:

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Volunteer Application

Education

References

Employment

Military Service

Disclaimer and Signature