PBS39 Volunteer Application
Application for for prospective volunteers for PBS39 in Fort Wayne, Indiana
Email address *
First Name *
Your answer
Middle Initial
Your answer
Last Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Phone Number *
Your answer
If you gave us your cell phone as the number you'd like us to contact you at, may we send you text messages? *
Social Security Number *
Your answer
Please Note:
PBS39 requires a Social Security Number as part of our volunteer screening process. Please know that all information you choose to share with PBS39, on this form or anywhere else remains secure with us and is not ever bartered, shared, traded or sold to any other party, ever.
Email Preferences
We like to keep volunteers informed of important news, station events, schedule changes and other information as well as volunteer opportunities Use the check boxes following to select the types of emails you would like to receive. Check all that apply.
My Email Preferences are:
Let Us Know More About You
Please fill out the following fields to the best of your abilities. Please note those denoted with an asterisk are required fields and must be filled out to complete this form.
What is your birthday?
MM
/
DD
/
YYYY
Have you ever been convicted of a felony? *
Are you currently a member or donor to PBS39? *
Are you currently employed? *
Times you're available to volunteer with PBS39
Skills and Interests
Please take a moment to share with any areas of interest you may have in volunteering with PBS39.
Are you able to lift 25+ Pounds? *
Skills and Interests I have: *
Required
If you answered "Other," please describe other interests or skills you wish to share.
Your answer
Affirmation/Signature:
I, the undersigned, by affixing my signature to this form either in print or electronically, affirm that all the information I have provided is true and complete to the best of my knowledge. If this application leads to being accepted to volunteer with PBS39, I understand that false or misleading information in my application or subsequent interview may result in my release from volunteer service with PBS39.
Type your name on the line below. *
Your answer
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