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New Volunteer Committee Application
Section I:
General Information
Estimated time to complete survey is 5 minutes. Please complete survey in one session.
Your responses are not saved until you submit the survey in Section III (page 3).
Personal and Contact Information
*
1.
First Name
(Required.)
*
2.
Last Name
(Required.)
*
3.
Birthdate (MM/DD/YYYY)
(Required.)
*
4.
Gender
(Required.)
*
5.
Are you of Hispanic, Latino, or of Spanish origin?
(Required.)
Yes
No
*
6.
Which of the following do you best identify with?
(Required.)
Black or African American
Native American
Asian
Native Hawaiian or Other Pacific Islander
White, non-Hispanic
White, Hispanic
Other (please specify)
*
7.
Phone Number
(Required.)
*
8.
Street Address
(Required.)
*
9.
City
(Required.)
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10.
State
(Required.)
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11.
Zip Code
(Required.)
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12.
Email Address
(Required.)
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13.
Adult T-Shirt Size
(Required.)
Small
Medium
Large
XL
XXL
Occupation and Education Information
*
14.
What is your occupation?
(Required.)
*
15.
Who is your employer?
(Required.)
*
16.
What is the highest level of school you have completed or the highest degree you have received?
(Required.)
Less than high school degree
High school degree or equivalent (e.g., GED)
Some college but no degree
Associate degree
Bachelor degree
Graduate degree or Professional degree
17.
If you attended college or university, please list the school name and major
School Name 1:
Major 1:
School Name 2:
Major 2:
School Name 3:
Major 3:
Criminal History Information
*
18.
Have you ever been convicted of or pleaded "guilty" or "no contest" to a felony or misdemeanor as an adult or juvenile?
(Required.)
Yes
No
*
19.
Are you currently charged with a felony or misdemeanor?
(Required.)
Yes
No
*
20.
Have you been or are you currently being investigated for allegedly abusing, neglecting, or exploiting a child, an elderly person, or a person with disabilities?
(Required.)
Yes
No
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