VTC Enterprises Volunteer Application Form Volunteer Application APPLICANT INFORMATIONName* First Middle Last Date* Address* Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Cell*Email Address* In Case of Emergency, Whom Should We Contact?* First Relationship:*Phone*Have you ever volunteered at VTC Enterprises?* Yes No If so, When? What Department?Why did you leave?Are you at least age 18?*YesNoGENERAL INFORMATIONAvailable Start Date Days/Time Available* Sunday From : HH MM AM PM To : HH MM AM PM Monday From : HH MM AM PM To : HH MM AM PM Tuesday From : HH MM AM PM To : HH MM AM PM Wednesday From : HH MM AM PM To : HH MM AM PM Thursday From : HH MM AM PM To : HH MM AM PM Friday From : HH MM AM PM To : HH MM AM PM Saturday From : HH MM AM PM To : HH MM AM PM What departments or programs are you most interested in?*How did you learn about VTC's Volunteer Program?*Do you speak another language other than English?*YesNoIf yes, what language?EDUCATIONHigh School*Location:*From To Did you graduate?*YesNoDiplomaCollegeLocation:From To Did you graduate?YesNoDegreeOtherLocation:From To Did you graduate?YesNoDegreeREFERENCESPlease list three personal references.Full Name First Last CompanyPhoneFull Name First Last CompanyPhoneFull Name First Last CompanyPhonePREVIOUS EMPLOYMENT OR VOLUNTEER EXPERIENCEPlease start with most currentCompany #1*Phone*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Supervisor* First Last Job TitleResponsibilitiesFrom To Reason for LeavingCompany #2PhoneAddress Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code SupervisorJob TitleResponsibilitiesFrom To Reason for LeavingI have answered each question fully and correctly. I understand that any deliberate misstatement will disqualify me, or will cause immediate termination of my volunteer assignment. I authorize VTC Enterprises to fully investigate my references. I understand that in accordance with VTC Enterprises, volunteer placement is conditional upon satisfactory clearance by the criminal background check. I hereby agree that I will keep confidential materials I may read or learn about during my work here as a volunteer. In this regard, I will only discuss this information with appropriate staff and will never, under any circumstances, reveal the name of a client. Signature* First Date* CAPTCHA
