Volunteer Application Form

Please complete this application form if you are interested in becoming a City of Plymouth volunteer.

1. Review the application first to make sure you have all the required information available before you begin.

2. Fill out the application form completely as you cannot return to complete it later.

3. Once you have completed the form, click the "Continue" button at the bottom.

Information collected is being transmitted via a secure connection using SSL and will only be used to process your volunteer application.

Contact Information

* indicates a required field.

First name:

Last name:

Street 1:

Street 2:

City:

State:

* Zip: *

Home phone:

Work phone:

Cell phone:

Email address:

Emergency Contact

EMERGENCY CONTACT INFORMATION IS REQUIRED FOR PLACEMENT

First name:

Last name:

Street 1:

Street 2:

City:

State:

Zip:

Home phone:

Work phone:

Cell phone:

Relationship:

Employment

Please list your current or most recent employer, if applicable.

Employer:

Job Title:

Please list last two previous employers and positions.

Education

Please choose the highest level of education completed.

Education:

Provide additional relevant information on certificates, degrees or schools attended.

Skills/Additional Languages

In which of these areas do you feel you have moderate to excellent skill? Check all that apply.

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. Only City of Plymouth Volunteer Services staff will view this information.

Gender:

Ethnicity:

Age Group:

Availability

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

References

REFERENCES ARE REQUIRED FOR PLACEMENT

Please provide three personal, work or academic references with complete addresses.

1

2

First name:

Last name:

Street 1:

Street 2:

City:

State:

Zip:

Home phone:

Work phone:

Cell phone:

Email address:

Relationship:

3

First name:

Last name:

Street 1:

Street 2:

City:

State:

Zip:

Home phone:

Work phone:

Cell phone:

Email address:

Relationship:

Recruitment Source

* indicates a required field.

I Agree

I give my permission to check the references that I have listed. I certify that the facts set forth in the volunteer application are true to the best of my knowledge. I understand that any falsification, misrepresentation or concealment of information on this application may be sufficient grounds for disqualification for volunteering or immediate discharge and that the City of Plymouth shall not be liable in any respect if my volunteering is so denied or terminated. I understand that I am applying for a volunteer position and that I will not be paid in any way. I understand that a background check may be required for certain volunteer positions.

If I am selected as a volunteer for the City of Plymouth, I give my permission for photo/video footage taken of me working as a volunteer to be used by the City of Plymouth for marketing purposes.

TENNESSEN WARNING

In accordance with the Minnesota Government Data Practices Act, the City of Plymouth is required to inform you of your rights as they relate to the personal information collected from you. Minnesota Statutes §§ 13.04 and 13.43 are two sections that govern what affects you as an applicant for volunteering with the City of Plymouth.

Minnesota law requires that you be informed of the purposes and intended uses of the information you provide to the City of Plymouth during the application process or during volunteer assignments. Any information about yourself that you provide during the application and interview process will be used to distinguish you from other applicants, identify you in our program records and enable us to contact you.

The following information which you will be asked to provide in this application process is considered private data: name, address, home phone number, gender and age group. Private data is available only to you and to other persons at the City of Plymouth who have a bona fide need for that data. Your name is considered private information; however, if you are selected to volunteer with the City of Plymouth, your name becomes public information.

Public data is available to anyone requesting it and consists of all data furnished in the application process which is not designated in this notice as private data. Please note that the City does not share information gathered through its sites with third parties for promotional purposes.

Although you are not legally required to supply information, if you do not supply the information requested, it may mean that your application is not considered.

I declare that I have read and understand the information given above regarding the Minnesota Data Privacy Act.

I Agree