Individual Volunteer Application Form
RequiredRequired Question(s)
Required 1.
Today's Date:
 

50 characters left.
Required 2.
Name:
 

50 characters left.
Required 3.

Date of birth: 


 

50 characters left.
Required 4.

Phone number: 

 

50 characters left.
Required 5.

Email Address: 

 

50 characters left.
Required 6.
Address:
 

50 characters left.
Required 7.
City/State:
 

50 characters left.
Required 8.

Zip code: 

 

50 characters left.
9.

Employer (If employed): 

 

50 characters left.
10.

Employer phone number: 


 

50 characters left.
11.

Employer address: 

 

50 characters left.
12.
May you be called at work?
Yes
No
13.

Brief description of work: 

 

350 characters left.
Required 14.

Formal education (highest year of school completed): 

 

50 characters left.
Required 15.

Do you speak a language other than English? If yes, which language? 

Yes
No
  • Comment:

  • 500 characters left.
Required 16.

Do you drive? 

Yes
No
17.
If you do drive, do you have regular access to a car?
Yes
No
18.

Current community activities: 

 

350 characters left.
19.

Please list current and previous volunteer work (list all volunteer work including brief descriptions of duties and activities): 

 

1000 characters left.
Required 20.

Why are you interested in volunteering for Peace Learning Center? 

 

1000 characters left.
Required 21.

How did you learn about our volunteer program? 

 

350 characters left.
Required 22.

If working with children, do you consent to a routine background check? 

Yes
No
  • Comment:

  • 500 characters left.
For the next three questions, please list three references of people who know you well, other than relatives, preferably for whom you have worked in either a paid or volunteer capacity. If you are currently working, either for paid employment or as a volunteer, please include your current supervisor.
 
Required 23.

Reference #1 - Name, Address, Zip Code, Phone, and Relationship:  


 

350 characters left.
Required 24.

Reference #2 - Name, Address, Zip Code, Phone, and Relationship:  

 

350 characters left.
Required 25.

Reference #3 - Name, Address, Zip Code, Phone, and Relationship: 

 

350 characters left.
Peace Learning Center reserves the right to make any checks deemed appropriate. All information obtained will be held in the strictest confidence.