Please complete this application form if you are interested in becoming a City of Alexandria Recreation, Parks, and Cultural Activities volunteer. Once you complete the form, click the continue button at the bottom and someone will contact you from the department.

Name

First name:

Last name:

Title:

Demographic Information

Street 1:

City:

State:

* Zip: *

Home phone:

* OK to call me here

Work phone:

* OK to call me here

Cell phone:

Email Address

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email if you prefer not to receive.

Email address:

What kinds of email would you like to receive?

Electronic newsletters

Recruitment appeals

Birthdate

(MM/DD: include year if under 18):

Date of birth:

Emergency Contact Name

First name:

Last name:

Street 1:

City:

State:

Zip:

Home phone:

Work phone:

Cell phone:

Email address:

Relationship:

Occupational Background

Employer name:

First name:

Last name:

Title:

Street 1:

City:

State:

Zip:

Work phone:

Relationship:

Personal reference

Employer name:

First name:

Last name:

Title:

City:

State:

Zip:

Work phone:

Cell phone:

Relationship:

Indicate your interest of task/duties.

Volunteer Group

Please complete only if you are applying as a group of volunteers.

Describe your special skills and languages.

Education

Please select the highest level of education completed and the name of the school.

Education:

School:

Are your volunteer hours required?

If yes, please use this section to provide deadline for completion, total hours needed, and who's requiring the service requirement(class, school, court-ordered, etc.)

Agreement

I certify that the information provided on this application is true and complete to the best of my knowledge, and agree that falsified information or significant omissions may disqualify me from further consideration for volunteering and if I am accepted to be a volunteer, will result in my dismissal when discovered. I understand that, if accepted as a volunteer, I will be required to abide by all of the policies, rules and regulations of the Department of Recreation, Parks, and Cultural Activities (RPCA) and volunteer program. I authorize RPCA to investigate all statements contained in this application and to make inquiries of my personal reference and volunteer history, as well as other related matters as may be necessary for arriving at a decision of acceptance into the volunteer program. I hereby release employers, schools or individuals from all liability in responding to inquiries relative to my volunteer application.

I Agree