Mano-a-Mano-Volunteer-Application
- 1. Mano a Mano Family Resource Center PROGRAM VOLUNTEER APPLICATION All volunteer applicants are considered without regard to race, color, gender, religion, national origin, age, marital or veteran status, mental or physical disability unrelated to job performance or any other legally protected status. VOLUNTEER POSITION APPLYING FOR: _________________________ DATE: __________ PERSONAL INFORMATION ______________________________________________________________________________________ Legal name: First Last Middle Initial ______________________________________________________________________________________ Address: Street City State Zip code Home Telephone: _________________________ Other Telephone: __________________________ E-mail: ___________________________________ Social Security #: __________________________ Driver’s License #: ___________________________________ State: __________________________ (if position requires operation of a company vehicle) Have you ever been convicted of a crime? Yes No If yes, please explain circumstances: ____________________________________________________ _____________________________________________________________________________________ Are you at least 18 years old? Yes No POSITION INFORMATION When are you available to volunteer? _______________________________________________ When could you start? __________________________________________________________ How did you hear about this volunteer opportunity? _______________________________________
- 2. EMPLOYMENT / VOLUNTEER HISTORY (Most recent first) 1. Job Title: Employer: Dates of Employment (month / year) From: To: Duties: Full Time Part Time Temp Employer’s Address: Supervisor: May we contact? Yes No Phone: Reason for Leaving: 2. Job Title: Employer: Dates of Employment (month / year) From: To: Duties: Full Time Part Time Temp Employer’s Address: Supervisor: May we contact? Yes No Phone: Reason for Leaving: 3. Job Title: Employer: Dates of Employment (month / year) From: To: Duties: Full Time Part Time Temp Employer’s Address: Supervisor: May we contact? Yes No Phone: Reason for Leaving: 4. Job Title: Employer: Dates of Employment (month / year) From: To: Duties: Full Time Part Time Temp Employer’s Address: Supervisor: May we contact? Yes No Phone: Reason for Leaving:
- 3. EDUCATION Type of school Name and Location Dates Attended Degree Received Subjects Studied Did you graduate? High School College / University Graduate School Tech School Other Special courses, training or experience acquired, including military experience: ________________ ______________________________________________________________________________________ ______________________________________________________________________________________ SKILLS Clerical / Office skills Computer skills Name of software: PC Mac WPM Languages Other special knowledge or skills Please describe any other experience, abilities or skills that might be helpful in considering your application: ___________________________________________________________________________ ______________________________________________________________________________________ CERTIFICATION & AUTHORIZATION I hereby certify that all statements made in this application are true and correct to the best of my knowledge and belief. I authorize Mano a Mano to inquire into my educational, professional and past employment history references as needed to research my qualifications for this position and to perform a background check if working with children. I agree to conform to the rules, regulations and policies of Mano a Mano. I hereby acknowledge that I have read and fully understand this application. _____________________________________________ ____________________ Signature of Applicant Date