Volunteer Application - Perry County Council Of The Arts
Thank you for your interest in volunteering with PCCA!
Please complete the questionaire below.
Our volunteer coordinator will be in touch shortly regarding your application.
Contact Information
Last Name
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First Name
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Street Address
Example: 123 Main Street
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City
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State
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Zip Code
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Primary Phone Number
Please include area code.
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Email Address
If you do not use e-mail, enter "None"
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Secondary E-mail Address
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Availability
During which time/days are you are you available for volunteer assignments?
Please select all that apply.
Required
Tell us in which areas you are interested in volunteering.
Please select all that apply.
Required
Special Skills or Qualifications
Summarize special skills and qulifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.
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Previous Volunteer Experience
Summarize your previous volunteer experience
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Person To Notify In Case of Emergency
Person to Notify in Case of an Emergency
Last, First
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Street Address
Example: 123 Main Street
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City, State, Zip
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Primary Phone
Please include area code
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Work Phone
Please include area code
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E-mail Address
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Our Policy
It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.
Volunteer Agreement
By typing my name below and submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer any false statements, ommissions, or other misrepresentations made by me on this application may result in my immediate dismissal.
Full Name
By typing your full name below you are indicating your acceptance of the above volunteer agreement.
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Today's Date
MM/DD/YY
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