Pg 1: WOMEN EMPOWERING GIRLS VOLUNTEER FORM 2019
Email address *
First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
City/State/Zip *
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Telephone *
Your answer
Date of Birth *
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Physical Limitations: *
If selected "Yes," above please further explain.
Your answer
Education (highest level completed) *
"Have you ever been Convicted, Charged or Arrested of a crime, included DUI?" (This is confidential and will not disqualify you). *
If the Answered Yes to Above Question Please Explain (This is confidential and will not disqualify you).
Your answer
Former work/occupation *
Your answer
List previous volunteer experience
Your answer
Skills (List your skills and indicate proficiency level)...Note whether you are Skilled; Can Teach; Amateur beside each skill.
Your answer
Languages...Note whether you are Fluent; Read; Write beside each language.
Your answer
Volunteer Availability Days. *
Transportation (How will you get to your assignment?): *
In an emergency, notify:
Name *
Your answer
Telephone Number *
Your answer
Volunteers hereby agree to serve any client who is assigned to regardless of race, sex, creed or national origin. IF UNDER 18, PARENT/GUARDIAN MUST COMPLETE FOR CONSENT.
Name *
Your answer
Today's Date *
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