Volunteer Application Question Title * 1. Please fill out the information below: Name: Address: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Email Address: Phone Number: Question Title * 2. What is your age? Under 18 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 or older Question Title * 3. What is the highest level of school you have completed or the highest degree you have received? Less than high school degree High school degree or equivalent (e.g., GED) Some college but no degree Associate degree Bachelor degree Graduate degree Question Title * 4. Have you ever been convicted of a felony? Yes No If yes, please specify. Question Title * 5. Are you currently employed? Yes No Question Title * 6. If so, where are you employed? Question Title * 7. How did you learn about the Hult Center for Healthy Living? Question Title * 8. Are you requesting volunteers hours for required community service? If so, please explain. Question Title * 9. Please select area(s) of interest: Healthy Heroes Youth Programs Encore/Senior Programs Mental Health Programs Fundraising/Special Events Miscellaneous Projects Other (please specify) Question Title * 10. What is your availability for volunteering? (ie. days of the week, times, etc.) Question Title * 11. Describe any experience, skills, or talents you have that would be useful in your volunteer work. Please include former volunteering and paid work experiences. Question Title * 12. List interests and hobbies? Question Title * 13. Please list three references you have known for at least five years, but are not related to you: Name Title Phone Number Years Known Name Title Phone Number Years Known Name Title Phone Number Years Known Question Title * 14. By signing my name below I understand that any false or misleading information furnished by me in this application form, or in connection with my application, may result in my dismissal. Done