Volunteer Application
LifeLine CDC Volunteer Application
Name: *
Your answer
Address:
Your answer
Email: *
Your answer
Phone: *
Your answer
Skills and Interests
Education Background:
Your answer
Current Occupation:
Your answer
Hobbies, Interests, Skills:
Your answer
Previous Volunteer Experience:
Your answer
Why do you want to volunteer with this organization?
Your answer
Is there a particular type of volunteer work in which you are interested?
Your answer
Is there a person or group with whom you are particularly interested in working? (Choose all that apply)
Are there any groups you would not feel comfortable working with?
II. Availability
At what times are you interested in volunteering? (Circle all that apply)
Do you have a geography preference as to where you do volunteer work?
Do you have access to an automobile you can use for volunteer work?
How did you hear from us?
Your answer
List name addresses and phone/email of three non-family members who can provide reference on your ability to perform this volunteer position.
Name:
Your answer
Name:
Your answer
Name:
Your answer
May we have your permission to contact the above named references, and perform any other screening measures, such as, medical exam, driver’s record, and/or police check?
Signature:
Your answer
Date:
MM
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YYYY
Thank You!
Thank you for using your gifts, passions and dreams to further the cause of empowering neighborhoods.

For the protection of our community, we will do background checks on all supervisory roles.

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