Please complete this application form when applying for volunteer assignments with agencies and programs of the Polk County Board of County Commissioners ONLY. If you are uncertain if this pertains to your assignment of interest, please contact us at or 863-534-5580. After receiving your application, you will receive an automatic email reply confirming receipt of your information. Processing time can vary, depending on the number of applicants being processed at the time of receipt and the availability of volunteer office support to assist in the processing. If you have not heard from someone regarding your placement after two weeks, please make inquiry!

If you are interested in an internship, in addition to submitting your volunteer application, please e-mail a copy of your resume to

Name and Contact Information

Emergency Contact Information

In case of injury or distress, who should we or your volunteer supervisor contact?

Demographic Information

The following information is optional. It is used only to help get an idea of the demographic make-up of our volunteers and for possible qualification of occasional grant funding.

Availability and Location

Check which days and times you are available. Then choose as many of the options below that apply to where you are willing to or need to be assigned.

Skills and Experience

Letting us know your skills helps to identify alternative placements if the assignment(s) you choose become unavailable.

Assignment Preferences

Assignments not currently accepting new volunteers are indicated by the word "full" after the assignment title. If you select a "full" assignment and have not yet spoken with the site of interest directly, you will be placed on a wait list.

Reminder: If selecting an internship please email your resume to

How did you hear about us?

Let us know how you heard of Volunteer Polk. Select the most accurate option. If "other" please explain.


Screening Agreement

Minimum required screenings include a background screen and search on the National Sex Offender Registry. Some assignments due to their involvement with vulnerable populations, will require higher levels of screens than others. To help the proper processing of your application, please supply the following information. Aliases include premarital names or versions of your name that have been used (i.e Johnson, Smith, and Johnson-Smith or Smith-Johnson).

Authorization of Background Screening

By selecting "I agree." you allow Volunteer Polk to use your personal information to assign you to a Polk County Board of County Commissioners' agency/program and to conduct the necessary screens for your placement. You also agree that you have reviewed the assignment qualifications and feel that you meet the minimum requirements for placement.