First Name
Last Name
Address 1
Address 2
city
state
zip
Home phone
cell phone / pager
work phone
employer
email
month and date of birth
home
work
cell/pager
preferred phone number
Ethnicity (optional)
african american
asian / pacific islander
latina / latino
native american
mixed ethnicity
white
Age Group
under 18
18-25
26-35
36-45
46-55
56-65
over 65
Education
high school / ged
college
graduate
other
Employment
job title / description
organization / company
Languages
please list any languages other than english that you are able to speak, read or write fluently
language
speak
read
write
speak
read
write
speak
read
write
Emergency Contact Information
name
relationship
daytime phone
evening phone
how did you hear about girls inc?
girls inc. volunteer
friend
girls inc. staff member
newspaper
girls inc. participant
television
school
volunteer match
employer
community fair
girls inc. web site
craig's list
live in san leandro
girls inc. mailing
other
would you like to be added to our list to receive monthly email updates about volunteer opportunities at girls inc.?
yes
no
would you be willing to submit to a criminal background check if required for your volunteer assignment?
yes
no
Your answers to the following questions will help us find the most appropriate volunteer placement for you at girls inc.
Volunteer Experience
please list your most recent volunteer activities
activity
organization
duration
activity
organization
duration
Skills and Interests
please list the areas of your volunteer interest and/or the position for which you are applying.
please list any skills you would like to enhance or develop through your volunteer work with girls inc.
please list any skills, hobbies, interests or certifications you possess that may be helpful in your volunteer work
why do you want to volunteer with girls inc.?
all of the above information is accurate and correct to the best of my knowledge
signature
today's date
Girls inc. is not obligated to provide a volunteer placement for you, nor are you obligated to accept any position offered.
You may either: (a) Submit this form via the web -or- (b) print this form, and fax it to Girls Inc.