Volunteer Application

Applicant Information

Please tell us a little about yourself.

First Name *

Last Name *

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Email *

Primary Phone *

Cell Phone

Date of Birth

Gender

Emergency Contact Information

[forminator_form id="7464"]

First Name

Last Name

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Primary Phone

Alternative Phone

Educational Information

High School/GED

Name

Location

Course of Study

Level Completed

Did you graduate?YesNo

Vocational School

Name

Location

Course of Study

Level Completed

Did you graduate?YesNo

College/University

Name

Location

Course of Study

Level Completed

Did you graduate?YesNo

Special Courses/Other

Name

Location

Course of Study

Level Completed

Did you graduate?YesNo

References

Please list names, relationships and phone number to 3 references.

Reference 1 Name

Relationship

Phone

Reference 2 Name

Relationship

Phone

Reference 3 Name

Relationship

Phone

Additional Information

Do you have any health problems/ physical disabilities which would prevent you from performing certain kinds of work?YesNo

Please explain

have you served as a volunteer before?YesNo

Where and in what roles have you volunteered?

Are you willing to make a 12-month commitment?YesNo

Have you been convicted of a crime, other than minor traffic violation(s)?YesNo

Please explain

Do you have reliable transportation?YesNo

Do you have a valid driver's license?YesNo

License State/Number

Background Checks

In order to ensure the safety of volunteers, the victims and the offenders, we use many methods of screening, including criminal background checks.

Are you willing to allow us to conduct a thorough background check?YesNo

First Name

Last Name

Date

Elevating People by Eliminating Barriers to Employment

Eau Claire County Restorative Justice