If you are human, leave this field blank.
City, State, Zip
Drivers License Number / Issuing State
Religious Affiliation (optional)
Have you been convicted of a crime more serious than a minor traffic violation?
If yes, please state the type of crime(s) and circumstances with regard to each, including date of the conviction or plea and the penalty, if any, imposed by the court.
AVAILABILITY: During which hours are you available for volunteer assignments?
** If part-time resident, what months are you available?
INTERESTS: Tell us in which areas you are interested in volunteering
Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies, sports or foreign languages you speak.
Summarize your previous volunteer experience.
REFERENCE: Email Address
Signature (typed in lieu of signature)
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. Thank you for completing this application form and for your interest in volunteering with Naples Senior Center at JFCS.