Volunteer Application

(please print, fill out & mail along with the volunteer opportunities list)

 

Name: ___________________________________________________________   Date: _____________

            (Last)                                      (First)                                      (M.I.)

 

Address: __________________________________________                    Home #: __________________

 

City: ___________________  State: _____  Zip: __________                     Work #: __________________

 

Education: _________________________________________                    D.O.B.:  __________________

                                                                                                                                (year optional)    

Emergency Contact:

_____________________________________________________________________________________

            (Name)                                              (Relationship)                  (Home #)                  (Work#)

 

Limitations Related to Health: __________________________________________________________

 

Have you volunteered with Skyland Trail before?   Yes ______     No ______

 

            If yes, when? _____________________                    What Capacity? ________________________

 

Volunteer Experience            _________________________________________________________________

 

_____________________________________________________________________________________

 

Why do you want to volunteer with Skyland Trail? _________________________________________

 

_____________________________________________________________________________________

 

Do you have a preference for: General Volunteering  ______   or Direct Service Volunteering _____

 

                                                (No preference) ______

 

Please list hobbies, interests, special abilities, etc. ___________________________________________

 

_____________________________________________________________________________________

 

Please list any foreign/sign language skills ________________________________________________

 

How did you hear about Skyland Trail? __________________________________________________

 

Do you know anyone who would be interested in receiving a volunteer information packet? Please provide name (s) and address (es). _______________________________________________________

 

_____________________________________________________________________________________

 

_____________________________________________________________________________________

 

Would you like your name added to our mailing list?  Yes ______  No ______

 

 

 

Times Available: please (*) your preferred times.

 

 

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Morning

 

 

 

 

 

 

 

Afternoon

 

 

 

 

 

 

 

Evening

 

 

 

 

 

 

 

 

References: (Professional associates, friends, former employers, other volunteers, teachers or community leaders)

 

            Name: __________________________                       Address: ______________________________

           

            Phone: __________________________                                     ______________________________

 

 

            Name: __________________________                      Address: ______________________________

 

            Phone: __________________________                                     ______________________________

 

CERTIFICATION BY APPLICANT

 

Applicant’s Statement: (Please read carefully before signing)

 

I hereby certify that all information given on this application is true and correct to the best of my knowledge, without consequential or significant omissions of any kind. I authorize Skyland Trail to conduct a thorough inquiry of my personal character to verify the data provided herein, and I agree to release from liability any person giving or receiving information in connection with this inquiry.

 

I understand that my healthcare insurance coverage is considered to be the primary coverage in the event of an injury at Skyland Trail during my time as a volunteer.

 

I understand that any misrepresentation I make may be cause for non-acceptance as a volunteer. If qualified for volunteer services, I agree:

(1)   To abide by the rules and regulations of Skyland Trail.

(2)   To attend all orientation training.

(3)   To make myself available at least twice a month, for a minimum of six months of actual service.

 

________________________________

            (Applicant’s Signature)

 

-------------------------------------------------------------------------------------------------------------------------------

OFFICE USE ONLY

 

Start date: ______________                        End date: _____________________

Position: ___________________        Supervisor: ____________________

Comments: _____________________________________________

____________________________________________________