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» Corrections Volunteer Application
Corrections Volunteer Application
Personal Information
Name
*
first and last name
Address
*
street address, city, state
Primary Phone #
*
ex. 111-222-3333
Secondary Phone #
ex. 111-222-3333
E-mail Address
*
Birthdate
*
MM-DD-YYYY
Marital Status
*
Married
Not-Married
Employment
Present Employer
*
Employer Address
Street address, city, state
Start Date
MM-DD-YYYY
Work Phone
Education/Military Service
High School
*
City/State
*
HS Grad Year
College/University
College Grad Year
Degree
Military Service
- None -
Active Duty
Reserve
Retired
Branch
Dates of Service
MM-DD-YYYY - to - MM-DD-YYYY
Criminal History
Are you currently on probation/parole?
*
Yes
No
If you answered Yes, please explain (dates, state, charges, etc.)
If you answer
Have you ever been convicted of a misdemeanor or felony as an adult?
*
Yes
No
If you answered Yes, please explain (date, state/county, duration, outcome, etc
Have you ever been on probation/parole?
*
Yes
No
In case of emergency during volunteer work
Emergency Contact
*
first and last name
Relationship
*
This contact is related to you in what way?
Daytime Phone
*
ex. 111-222-3333
Evening Phone
*
ex. 111-222-3333
Just for Fun
If you had to describe yourself in 1 word, what would that one word be?
*
What would you like to do as a volunteer?
*
Please be specific about working with adults or juveniles. If you’re not sure what you would like to do, please review the volunteer positions descriptions to check out our needs.
Leave this field blank