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VOLUNTEER APPLICATION. FUNDACION MISION REMA
Name: *
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Address: *
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City: *
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Zip Code: *
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Cell Phone: *
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Home Phone:
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Email: *
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Date of Birth: *
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Education:
Highest Level of Education *
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Where/ Country? *
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Employment
Current Employer, if applicable
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Position /Title: *
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Dates of Employment (Start): *
MM
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DD
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YYYY
Dates of Employment (Ending): *
MM
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DD
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YYYY
Company/Employer *
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Phone *
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Address *
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Hours/Time to spend on your volunteer service and achievement *
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Hours/Time to spend on your volunteer service and achievement *
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Special training, skills, hobbies *
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What experience have you had may prepare you to work as a volunteer in the field of cancer patient, or a related field? *
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Why do you want to volunteer? *
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Have you ever been convicted of a crime? If yes, explain the nature of the crime and the date of the conviction and disposition. Conviction of a crime is not an automatic disqualification for volunteer work. *
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Do you have: a Driver License *
Do you have Car insurance? *
Car available for transporting others? *
References
Please list three people who know you well and can attest to your character, skills, and responsibility
Reference 1. Name / Relationship / Phone *
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Reference 2. Name / Relationship / Phone *
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Reference 3. Name / Relationship / Phone *
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Please read the following carefully before signing this application:
I understand that this is an application for and not a commitment or promise of volunteer opportunity.

I certify that I have and will provide information throughout the selection process, including on this application for a volunteer position and in interviews with FUNDACION MISION REMA that is true, correct and complete to the best of my knowledge. Also, I have not and will not withhold any information that would unfavorably affect my application for a volunteer position. I understand that information contained on my application will be verified by FUNDACION MISION REMA. I UNDERSTAND that misrepresentations or omissions may be cause for my immediate rejection as an application for a volunteer position or my termination as a volunteer.

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