Volunteer Registration Form

Volunteer Registration Form

PNT proudly supports an active small business community that has grown within the organization by offering regular monthly networking events, professional development workshops, employment events and, small business expos. Small business is the backbone of our economy in this nation. We, the members of Power Networking Team, are the backbone of our local economy. As PNT and the small business community in our area grow stronger, we all win. PNT is a grass roots organization that is dependent on the leadership and the support of each member to stay strong. There is a role in this organization for you. You can make a valuable contribution to the success of PNT. If you see a need in our small business community that is unfilled, speak up and let’s find a way for PNT to be a first responder.
Full Name*

First NameLast Name
Legal Name of Business*
Nature of Business (what products and/or services does your business offer) *
Address*

Street Address

Street Address Line 2

CityState

Postal / Zip CodeCountry
E-mail*
Phone Number*

Area CodePhone Number
How did you hear about PNT?*

Volunteer Service Preferences *

	Would love to!	Not this area
Chapter Leader
Event Leader
Photographer
Host/Hostess
Registration

Time of Day Preferred for Volunteer Service*

	Morning	Afternoon	Evening	Weekend
Chapter Leader
Event Leader
Photographer
Host/Hostess
Registration

City of Preference (select three cities in order of priority)*
State of Preference*
Any special talents or skills that you have that you feel would benefit our organization?*
What experiences have you had that might prepare you to work as a volunteer? *
Why do you want to volunteer?*
What do you want to gain from this volunteer experience? *
Have you been convicted of a crime? (If yes, please explain the nature of the crime and the date of conviction and disposition. Conviction of a crime is not an automatic disqualification for volunteer work.*

YesNo
Explain the nature of the crime and the date of conviction and disposition.*
Please list any physical limitations*
By submitting this application, I understand that this is an application for and not a commitment or promise of volunteer opportunity. I certify that I have and will provide information throughout the selection process including on this application for a volunteer position and in interview with Power Networking Group that is true, correct and complete to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and that I have not and will not withhold any information that would unfavorably affect my application for a volunteer position. I understand that information contained on my application will be verified by Power Network Group. I understand that misrepresentations or omissions may cause for my immediate rejection as an applicant for a volunteer position with Power Networking Group or my termination as a volunteer. As a volunteer of our organization, I agree to abide by the policies and procedures. I understand that I will be volunteering at my own risk and that the organization, its employees and affiliates, cannot assume any responsibility for any liability for any accident, injury or health problem which may arise from any volunteer work I perform for the organization. I agree that all the work I do is on a volunteer basis and I am not eligible to receive any monetary payment.
Date*

MonthDayYear
Date
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