Volunteer Application

Name: *

Street address: *

City: *

State: *

Zip code: *

Primary phone number: *

Please include area code.

Alternate phone number:

Please include area code.

E-mail: *

What is the best day/time to contact you by phone, and at which number do you prefer to be reached?:

Date of birth: *

Gender: *

Male

Female

With which of the following ethnic groups do you most closely identify?: *

Employment history

(list most recent first)

Employer 1

Employer name:

Employment dates:

start and end dates with employer

Describe your work:

Reason for leaving:

Employer 2

Employer name:

Employment dates:

Describe your work:

Reason for leaving:

Employer 3

Employer name:

Employment dates:

Describe your work:

Reason for leaving:

References

Reference 1 name: *

Reference 1 phone: *

Reference 1 alternate phone:

Reference 1 relationship: *

Reference 2 name: *

Reference 2 phone: *

Reference 2 alternate phone:

Reference 2 relationship: *

Reference 3 name: *

Reference 3 phone: *

Reference 3 alternate phone: *

Reference 3 relationship: *

Please list any special accommodations you riquire.:

Educational background: *

Less than high school diploma

GED High School equivalency

High School diploma

Some college or Associates degree

Vocational college (graduated)

Undergraduate college degree

Graduate degree

Postgraduate degree (such as doctoral)

Please mark an X to the left of your highest educational level, or the highest degree you have obtained

Please list the highest degree you have obtained and/or license you hold: : *

Primary occupation/activity: *

Attending college

Employed

Retired

Other:

Please list all organizations with which you are currently affiliated and active.:

Please be sure to include civic, community, social, Etc.

Please check below to acknowledge

Check the box to agree with the statement below.: *

I agree

I agree to follow all volunteerprogram guidelines and understand that any violation will result in suspension and/or termination of the volunteering relationship.

Check the box to acknowledge the statement below.: *

I Understand

I understand that the National Federation of the Blind of Texas is not obligated to provide a reason for their decision in accepting or rejecting me as a volunteer.

I allow photographs: *

Yes

(optional) I agree to allow the National Federation of the Blind of Texas to use any photographic image of me taken while participating in the volunteer program. These images may be used in promotions or other related marketing materials.

By typing in my name below, I attest to the truthfulness of all information listed on this application and agree to all the above terms and conditions.

Type your full name: *

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Information

National

Divisions

State Convention

User login

Navigation

Volunteer Application

Employment history

References

Search

Like NFB of Texas

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