Volunteer Application - Perry County Council Of The Arts
Thank you for your interest in volunteering with PCCA!  
Please complete the questionnaire below.  
Our Community Engagement Coordinator will be in touch shortly regarding your application.
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Contact Information
Last Name *
First Name *
Street Address *
Example:  123 Main Street
City *
State *
Zip Code *
Primary Phone Number *
Please include area code.
Email Address *
If you do not use e-mail, enter "None"
Secondary E-mail Address
Are you willing to obtain: *
Please select all that apply.  Clearances should be dated no more than 12 months prior to volunteer's start date.  
I enjoy working with:
Tell us in which areas you are interested in volunteering. *
Prior Volunteer Experience
Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports. *
I have previously volunteered with the following organizations: *
Summarize your previous volunteer experience
Person to Notify in Case of an Emergency *
Last, First
Street Address *
Example:  123 Main Street
City, State, Zip *
Primary Phone *
Please include area code
Work Phone *
Please include area code
E-mail Address
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.
Today's Date *
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