Volunteer Application Form

Please complete this form if you are interested in becoming a Community Emergency Service volunteer.

All items with an asterisk (*) are required fields

APPLICANT INFORMATION

First name:

Last name:

Title:

Nickname:

Street 1:

Street 2:

City:

State:

* Zip: *

Home phone:

OK to call me here

Work phone:

OK to call me here

Cell phone:

Email address:

DEMOGRAPHICS

You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers and for grant funding.

Gender:

Ethnicity:

Marital status:

PERSON TO NOTIFY IN CASE OF EMERGENCY

First name:

Last name:

Home phone:

Work phone:

Cell phone:

Relationship:

HOW DID YOU LEARN ABOUT CES?

Please share with us how you learned about CES and indicate if you are affiliated with a specific church, volunteer group or employer.

Referral Source:

Affiliation:

WHY CES?

Please share why you are interested in volunteering with CES.

AVAILABILITY

Please indicate the days and times you are usually available to volunteer.

SKILLS & INTEREST

Please indicate any special skills, hobbies, interests, or abilities that you have (i.e. sewing, musical talents, fluent in Spanish)

ASSIGNMENT PREFERENCE

The following volunteer assignments may currently be available. You may click the assignment names to learn more about that assignment. Use this list to rank your top three assignment choices.

* Assignment Preference:

1st choice:

2nd choice:

3rd choice:

4th choice:

5th choice:

6th choice:

7th choice:

8th choice:

9th choice:

EMPLOYER

Please list your current or most recent employer. This information is helpful as some employers provide matching donations to non-profits.

Employer name:

City:

State:

Zip:

EDUCATION

If you are a current student, please indicate the school you are attending.

Education Level:

School:

BACKGROUND CHECK INFORMATION

A background screening is completed on each candidate. Please provide the following information. Please note this information is not used for any other purpose.

Date of birth:

COMMUNICATION

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.

I Agree

I understand and agree that submitting this application form does not automatically register me as a Community Emergency Service volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering.

By submitting this form, I attest that the information I have provided on the form is true and accurate.

I Agree