Volunteer Applicant Name:
*
First Name
Last Name
Home Email Address:
*
Home Address:
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone:
*
(###)
###
####
Birth Date:
*
MM
DD
YYYY
Gender:
*
Business | Company | Organization:
Position/Occupation:
Business Address:
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Work Phone:
(###)
###
####
Work Email:
Preferred Hours of Volunteer Availability:
Preferred Contact Method(s):
(Please check all preferred)
Volunteering Area(s):
*
(Please check all preferred)
If Other, please specify:
Reason for Volunteering:
If Other, please specify:
If applicable, please list your supervisor's name, phone number, # of hours required, and completion date:
Have you ever been convicted (found guilty) of a crime (including probation(s) before judgment), or are there any pending criminal charges awaiting a hearing in a court of law? Do not list any criminal charges for which records have been expunged:
*
If you answered YES, please describe/list all convictions:
Digitally signing this agreement has the same effect as manually signing a paper original.
*
As a volunteer for North Texas Area United Way I certify that I have received, read and understand the Volunteer Liability Waiver Form. Please enter your digital signature:
*
First Name
Last Name
