VOLUNTEER APPLICATION Complete the form below or download a printable copy here. Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone * (###) ### #### Availability * Please select all that are applicable. Mornings (Mon-Fri) Afternoons (Mon-Fri) Evenings (Mon-Fri) Weekends Interests: * Please tell us in which areas you are interested in volunteering. Administration Communications/Public Outreach Event Planning Fundraising Food Drives Youth Programming Community Infrastructure Projects Other (please specify) Commitment * How long do you plan to volunteer? One Time Only As Needed Other (please specify) If "Other", please explain * Previous Volunteer Experience * Occupation * past occupation if retired or not employed Special Talents or Skills * Other Helpful Information * such as education, general interests or hobbies, etc. Languages spoken * Contact Person in case of emergency * First Name Last Name Relationship * Phone * of contact person (###) ### #### References Please list three (3) persons we may call who are not family. Reference 1 * First Name Last Name Relationship * Phone * (###) ### #### Reference 2 * First Name Last Name Relationship * Phone * (###) ### #### Reference 3 * First Name Last Name Relationship * Phone (###) ### #### I hereby give my consent to contact my references; to contact my employers, past and present; and to conduct a background check. As a volunteer of the Historic Northeast-Midtown Association 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 an at-will basis and I am not eligible to receive any monetary payment or reward. Signature * Please type your signature as a confirmation that you agree to the above statement. Thank you for your interest in volunteering with the Groundwork NRG. We will be in touch soon!
