Clone of The Village - Volunteer Application

Volunteer Application

The fields with an asterisk (*) are required.
Contact Information
Full Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Home Phone *

Area Code Phone Number
Work Phone

Area Code Phone Number
E-mail *
Availability
During which hours are you available for volunteer assignments? Select all that apply.

Weekday Mornings Weekend Mornings Weekday Afternoons Weekend Afternoons Weekday Evenings Weekend Evenings

Interests
Tell us why you want to become a Village Volunteer.
Special Skills or Qualifications
Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.
Previous Volunteer Experience
Summarize your previous volunteer experience

Previous Work Experience

Starting with your most recent, summarize you previous work experience.
#1
Name of Employer
Start Date

Month Day Year
End Date

Month Day Year
Reason for Leaving
Supervisor Name

First Name Last Name
Supervisor Phone

Area Code Phone Number
#2
Name of Employer
Start Date

Month Day Year
End Date

Month Day Year
Reason for Leaving
Supervisor Name

First Name Last Name
Supervisor Phone

Area Code Phone Number
#3
Name of Employer
Start Date

Month Day Year
End Date

Month Day Year
Reason for Leaving
Supervisor Name

First Name Last Name
Supervisor Phone

Area Code Phone Number

References

The Village requires THREE references for each volunteer. Please provide all requested information for three persons we may contact. Please do NOT list relatives.
#1
Full Name *

First Name Last Name
Relationship *
Phone Number *

Area Code Phone Number
E-mail *
#2
Full Name *

First Name Last Name
Relationship *
Phone Number *

Area Code Phone Number
E-mail *
#3
Full Name *

First Name Last Name
Relationship *
Phone Number *

Area Code Phone Number
E-mail *

Agreement

I authorize North Florida Retirement Village to obtain and/or to conduct a consumer report analysis and investigation for employment purposes, including but not limited to initial employment, promotion, reassignment, retention of employment, and any other use not prohibited by law, before, during, and/or after my employment. These reports may contain information regarding my credit history, criminal record history, driving record history, and/or any other sources of information which are permissible by all governing laws pertaining to employment, insurance, or credit information, at the sole discretion of North Florida Retirement Village. I understand this information may be obtained from previous employers, companies, credit bureaus, corporations, law enforcement agencies, persons, educational institutions, and other agencies, businesses, and/or individuals. I authorize and direct any and all persons who may have information relevant to this consumer report to disclose it to North Florida Retirement Village or its agents, and I expressly release any and all persons, including but not limited to, those disclosing the information, North Florida Retirement Village, and its agents, from any and all liability as a result of such disclosure or request. I understand this release does not waive any and all rights that I may have under the Fair Credit Reporting Act. I further authorize that a photocopy or a facsimile copy of this authorization may be considered as valid as an original. This authorization is valid for current and any and all future reports. By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omission, or other misrepresentations made by me on this application may result in my immediate dismissal.
Click to agree to the terms stated above. *

I Agree.
Should be Empty:

Volunteer Application

Contact Information

Availability

Interests

Special Skills or Qualifications

Previous Volunteer Experience

Previous Work Experience

#1

#2

#3

References

#1

#2

#3

Agreement