Volunteer Registration Part 2 - The Children's Village

Area of Interest*

Volunteer
Mentor
Intern

Emergency Contact Name*

First Last

Emergency Contact Phone*

Are you:*

Employed
Student

Employment Information

Occupation

Work Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisor's Name

First Last

Supervisor's Phone

School Information

School Name

School Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Volunteer Information

How did you learn about The Children's Village Volunteer Program?*

Why do you want to volunteer with foster care youth?*

What are some of your hobbies (i.e. music, computers, sports, etc.)?

Have you volunteered for other organizations?*

Yes
No

Please list and indicate dates and responsibilities:

What days are you available to volunteer?

Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

What times are you able to volunteer?

Mornings
Afternoons
Evenings
Flexible

References

Reference #1 Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email

Reference #2 Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email

Additional Information

Have you ever been convicted of a crime?*

Yes
No

Please explain:

Do you have a driver's license?

Yes
No

Please enter license number:

State:

Car Plate Number (if applicable):

Any other comments for staff:

Digital Signature

Please type your name to confirm that all the above information is correct to the best of your knowledge:*

First Last

Name

This field is for validation purposes and should be left unchanged.