VARIETY OF ILLINOIS VOLUNTEER

VARIETY VOLUNTEER

Name

First Name

Last Name

Middle Initial

Address

Street

City

State

Zip

Contact Information

Day Phone

Eve. Phone

More About You

Are you a Youth Volunteer (17 and under)? Yes No

If yes, how old are you?

What is your educational background?

What is your occupation?

Do you have any limitations that will restrict your volunteering? Yes No

If yes, please explain:

Why do you want to volunteer here?

Do you have any past volunteer experience? Yes No

If yes, where?

What skills or talents would you like to use?

What do you want to gain from your volunteer experience?

How did you hear about us?

Emergency Contact

Name

Phone

Availability

This section will help determine the best days and times you would like to volunteer. Please mark all days and times you would be available.

Interest Inventory

This section will help you determine what volunteer activities you might like to participate in. Please check any of the below areas that you are interested in, or, Other and explain. Please check as many as you would like!

Fund Development	Variety Kids Events: museums, fishing, picnics, etc.
Fundraising Events: Golf Outings, Gala, etc	Direct service with disabled youth
Board or Committee Service	Administrative/Office Assistance
Marketing / Public Relations	Data Entry
Other:

References

Please list the names and phone numbers of two people who know you well and can attest to your character and skill. (Please do not list relatives.)

Agency Name

Contact Name

Street

City

State

Zip

Phone

Agency Name

Contact Name

Street

City

State

Zip

Phone

Submit Application

What is 3 + 1? (Anti-spam)

The above information is correct and complete to the best of my knowledge, without consequential omissions. I authorize the organizations and persons named to release any information requested regarding my service, character and qualifications. I understand and authorize the agency to do a background check, and realize my volunteer work is contingent on my police background check. I acknowledge the agency is not obligated to offer me a volunteer position. I further agree to release and hold harmless Variety – The Children’s Charity of Illinois, institutions and references listed above, and any law enforcement agency from all liability and any damage that may result from furnishing this information to you.

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