AALDC Volunteer Application Form
Last Name *
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First Name *
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Street Address *
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City *
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State (two letter abbreviation: ex. NY) *
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Zip Code *
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Phone number *
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Email *
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Current/Most Recent Employer *
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Current/Most Recent Position
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INTERESTS: Please tell us in which areas you are interested in volunteering (you can check more than one) *
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(OPTIONAL) Please list any specific interests or comments here:
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Please indicate days and times available: check and complete all that apply *
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Have you ever been convicted for violations of any laws, traffic or otherwise? *
If you answered YES to the last question, please explain. If you answered NO, please type N/A: *
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Do you have any physical condition that may limit your activities? *
If you answered YES to the last question, please explain. If you answered NO, please type N/A: *
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In case of emergency who should we contact? (include at least one name and phone number)
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Disclosure and Agreement: As a volunteer of the Atlantic Avenue Local Development Corporation I agree to abide by the policies and procedures. I understand that I will be volunteering at my own risk and that the organization, its Officers, Directors, Employees and Affiliates, cannot assume any responsibility for any liability for any accident, injury or health problem which may arise from any volunteer work I perform for the organization. I agree that all the work I do is on a volunteer basis and I am not eligible to receive any monetary payment or reward. I agree to provide a valid, current photo identification to Atlantic Avenue Local Development Corporation. *
Please type your full legal name to confirm that all answered provided are true and correct. *
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