Volunteer Form

Application Date*

Name*

Address (Street, City, ZIP)*

Email Address*

Phone Number

Why do you want to volunteer at North Point Lighthouse?*

What volunteer opportunities are you interested in?* What volunteer opportunities are you interested in?* Education Tour Guide Special Events Exhibits Other

Please explain:

Education Education High School College Post Graduate Other

Current Employer

Position/Title

Date of Employment

Company Address (Street, City, ZIP)

Please describe your prior volunteer experiences. (Include org. names and date of experience)

What are your hobbies which are related to the type of volunteer work in which you are interested?

List skills or special training. (I.e., Teaching, public speaking, data entry, photography)

List computer experience. (List programs used and comfort level in learning new programs)

Do you have an internet accessible computer?* Do you have an internet accessible computer?* Yes No

What are your top three personal qualities?*

Have you been convicted of a crime?* Have you been convicted of a crime?* Yes No

If "Yes", please explain.

Emergency Contact Full Name*

Relationship*

Phone Number*

1st Personal Reference Full Name*

Relationship*

Phone Number*

2nd Personal Reference Full Name*

Relationship*

Phone Number*

Please read the following carefully before signing this application: I understand that this is an application for and not a commitment or promise of volunteer opportunity. I certify that I have and will provide information throughout the selection process, including on this application for a volunteer position and in interviews with North Point Lighthouse that is true, correct and complete to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and that I have not and will not withhold any information that would unfavorably affect my application for a volunteer position. I understand that information contained on my application will be verified by North Point Lighthouse. I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant for a volunteer position with North Point Lighthouse or my termination as a volunteer. Please read the following carefully before signing this application: I understand that this is an application for and not a commitment or promise of volunteer opportunity. I certify that I have and will provide information throughout the selection process, including on this application for a volunteer position and in interviews with North Point Lighthouse that is true, correct and complete to the best of my knowledge. I certify that I have and will answer all questions to the best of my ability and that I have not and will not withhold any information that would unfavorably affect my application for a volunteer position. I understand that information contained on my application will be verified by North Point Lighthouse. I understand that misrepresentations or omissions may be cause for my immediate rejection as an applicant for a volunteer position with North Point Lighthouse or my termination as a volunteer. I Agree I Do Not Agree

E-Signature of Applicant

Date