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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your gender?

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* 4. Are you over 18 years of age:

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* 5. What is your age?

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* 6. Have you ever filed an application with us before? yes ____ no ____

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* 7. Have you ever volunteered with us before? yes ____ no ____

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* 8. Do any of your friends or relatives, other than spouse, volunteer here? yes ____ no ____

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* 9. Do any of your friends or relatives, other than spouse, work here? yes ____ no ____

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* 10. Are you prevented from lawfully becoming a volunteer in the USA yes ____ no ____

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* 11. Have you ever been convicted of a felony? yes ____ no ____

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* 12. Are you currently on probation or parole? yes ____ no _____

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* 13. Reason for wanting to volunteer here:_____________________________________________
Number of volunteer hours you would like or need:
Minimum ____
Maximum hours____

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* 14. Work Availability: (check each day available)

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* 15. Mornings _____ Afternoons _______ Either _________

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* 16. Which of the following categories best describes your employment status?

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