Volunteer Information
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First Name:
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Last Name:
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Date of Birth:
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Address:
Address 2:
*
City:
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State:
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Zip:
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Phone Number:
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Email:
Where did you hear about Boys & Girls Club?:
Volunteer Interests
What would you like to volunteer for:
I would like to volunteer for fundraising activities
I would like to volunteer for programming activities
I would like to volunteer for both fundraising and programming activities
Where can you volunteer at:
Downtown Club
School Site
Interest Inventory:
Tutoring
Coaching
Music
Languages
Arts & Crafts
Fundraising
Special Events
Mentoring
Office Help
Field Trip Chaperone
Carpentry
Fine Arts
Photography
Creative Writing/
Journalism
Leading Recreational Activities
Computer Instruction
Other Area(s)
(check all that apply)
Volunteer Availability
Date you can start:
(mm/dd/yyyy)
Preferred Site Location:
Downtown Club
School Site
Hours of Availability:
Monday
Tuesday
Wednesday
Thursday
Friday
Commitment:
One Time
Summer Only
School Year
Other
(check all that apply)
Total Hours:
#/Week:
#/Month:
#/Year:
#/Other:
Experience
Relevant Experience:
Current Occupation:
Level of Education:
Volunteer Experience:
References
Primary Reference
Name:
Relationship:
Phone Number:
Secondary Reference
Name:
Relationship:
Phone Number:
Application Signature
Have read and agree with the
Volunteer Applicant Agreement
.
I agree that in the course of considering my application, you may inquire to verify information considering my background including educational, criminal, and employment. I authorize educational institutions and references listed above to give you any and all information conserning my education employment and fitness to work with children and young people. I further agree to release and hold harmless the Boys & Girls Clubs of West Central Missouri, references and law enforcemetn from all liability and any damage that may result from releasing this information to you and or volunteering at on behalf of the Boys & Girls Clubs of West Central Missouri.
I understand that photographs/video tapes may be made of my volunteer activities. I fully authorize the BGCWCM without limitation, to copy, publish, and distrubute such photographs/video tapes. I waive all claims I may have against your organization and/or its agents, subsidiaries, or assignees related to the above photos/video tapes.
Signature:
Signature Date:
By entering your full name and date into the fields above, you are signing the volunteer application