Date of Birth M/D/Y
If Under 18, please enter parent(s)
or guardian(s) name with whom you live
Ethnicity: (optional)
Select one
African American
Asian
Pacific Islander
Latino/Hispanic
Caucasian
Other
State/Province:*
Select one
Alaska
Alabama
Arkansas
American Samoa
Arizona
California
Colorado
Connecticut
District Of Columbia
Delaware
Florida
Georgia
Guam
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Virgin Islands
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Nova Scotia
Northwest Territories
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
Aguascalientes
Baja California (Norte)
Baja California Sur
Campeche
Chiapas
Chihuahua
Coahuila
Colima
Distrito Federal
Durango
Guanajuato
Guerrero
Hidalgo
Jalisco
Mèxico (Edo).
Michoacán
Morelos
Nayarit
Nuevo Leûn
Oaxaca
Puebla
Querètaro
Quintana Roo
San Luis Potosì
Sinaloa
Sonora
Tabasco
Tamaulipas
Tlaxcala
Veracruz
Yucatán
Zacatecas
Do you speak other languages ie: spanish
(please specify which)
Where would you like to volunteer:
Please specify your program preference:
Multiple Selections Ok
How Many Hours a Week Would you Like
to Volunteer
1-4 hours
5 -12 hours
13 or more
Days You Are Available:
Hours Available:
Morning: 9AM-Noon
Afternoon: Noon-5PM
Evening: 5PM to 8PM
What is Your Occupation: If student,
please specify
Name of Employer or School:
If in School, what Grade:
Are you volunteering as part of a corporate
/ community program or organization, If YES, please
specify which one
Have you volunteered with us in the
past, if so when
Are you a parent of one of our members,
If so, who
Are you a former Boys & Girls Clubs
Member, if so, where
Have you ever been convicted of a misdemeanor or felony within the last seven years? if so, please provide a brief explanation.
Select One
No
Yes
Certification of Applicant
I certify that all statements
made in this application are true and correct. I understand
that any misstatement, misrepresentation, or omission of
material fact may result in my application being rejected;
or, if I have been offered a position as a volunteer, in
my offer being withdrawn. I also agree to submit my Social Security Number,
if required, for the purpose of a background check. I understand
that my application process will be not be complele until
I have been interviewed and received clearance by the Volunteer
Director.
I agree