MAIC Volunteer Application
Volunteer Information
Full Name *
Your answer
Preferred Name
Your answer
Birth Date *
Your answer
Address *
Your answer
Phone # *
Your answer
Email Address
Your answer
Preferred Contact Method
Your answer
Emergency Contact Information
Contact Full Name *
Your answer
Relationship to Volunteer *
Your answer
Phone # *
Your answer
References
Please include two references (who are not related to you) who can speak about your character, skills and qualifications.
Full Names *
Your answer
Phone #s *
Your answer
Email Addresses
Your answer
Relationships to Volunteer *
Your answer
Volunteer Background
Please list previous and/or current volunteer experiences. *
Your answer
Are you interested in volunteering for a specific program at MAIC? If so, please write your interest.
Your answer
Please choose areas of interest (you may be asked to help with a related project).
From the list above, what type of project are you thinking of?
Your answer
Are you currently employed or attending university? If so, please specify your employment field or major. *
Your answer
Do you have any medical conditions, allergies or medication(s) that the MAIC staff should know about? Please explain. *
Your answer
Have you been convicted of a crime? If so, please briefly describe the circumstances of the conviction(s), dates, and nature and place of the offense(s). *Note: a conviction does not necessarily prohibit you from participation. *
Your answer
Type your initials and today's date if you certify that the information provided in this application is true and correct to the best of your knowledge. *
Your answer
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