VTC Enterprises Volunteer Application Form Volunteer Application APPLICANT INFORMATIONName* First Middle Last Date* Date Format: MM slash DD slash YYYY 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? Date Format: MM slash DD slash YYYY What Department?Why did you leave?Are you at least age 18?*YesNoGENERAL INFORMATIONAvailable Start Date Date Format: MM slash DD slash YYYY 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 Date Format: MM slash DD slash YYYY To Date Format: MM slash DD slash YYYY Did you graduate?*YesNoDiplomaCollegeLocation:From Date Format: MM slash DD slash YYYY To Date Format: MM slash DD slash YYYY Did you graduate?YesNoDegreeOtherLocation:From Date Format: MM slash DD slash YYYY To Date Format: MM slash DD slash YYYY 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 Date Format: MM slash DD slash YYYY To Date Format: MM slash DD slash YYYY 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 Date Format: MM slash DD slash YYYY To Date Format: MM slash DD slash YYYY 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* Date Format: MM slash DD slash YYYY CAPTCHA
