Volunteer Application - Polk County Board of County Commissioners

Please complete this application form ONLY when applying for volunteer assignments of Polk County Board of County Commissioners programs. After submitting it, you will receive an email confirming receipt of your application. Processing varies depending on staffing and demand. If you have not heard from someone regarding your placement after two weeks, please make inquiry!

Basic Information

Completing this section in full assists in the processing of your application. Aliases include premarital names or versions of your name that have been used (i.e Johnson, Smith, and Johnson-Smith or Smith-Johnson).

Legal First Name:

Legal Last Name:

Middle name:

Title:

Nickname:

Age Category:

Date of birth:

Gender:

Education:

Shirt Size:

Ethnicity:

Aliases:

FL Drivers License or ID:

Contact Information

Street:

Apt/Ste/Unit/Lot:

City:

State:

* Zip: *

Home phone:

Cell phone:

Other phone:

Email address:

What kinds of email would you like to receive?

Opportunity Announcements

Opportunity Announcement emails are sent when a new opportunity is available and is either a one day project/event or is in immediate need of help.

Volunteer Recognition Event

Volunteer Recognition Event emails are sent in regards to ONLY the annual recognition event hosted by Volunteer Polk.

Program Updates

Program Update emails are sent when new features are available to you for access to your volunteer information, when new policies apply to the way volunteerism works in the county, or other important news about Volunteer Polk.

Emergency Contact Information

1

2

First name:

Last name:

Nickname:

Home phone:

Cell phone:

Other phone:

Email address:

Relationship:

3

4

First name:

Last name:

Nickname:

Home phone:

Cell phone:

Other phone:

Email address:

Relationship:

Assignment Preferences

Skills and Experience

How did you hear about us?

Recruitment:

Message

What would you like us to know?

RSVP Enrolled Volunteers ONLY

If you are age 55 or older, are you currently enrolled in RSVP Polk? (Michelle Shiver)

RSVP Enrolled:

Florida Retirement System

Please note the volunteer opportunities on this application are with locations that participate in the Florida Retirement System (FRS). If you are enrolled with FRS from any FRS participating location, have retired, and are now wanting to volunteer, please contact FRS. Depending on your retirement plan and recent activity on the plan you will need to determine how long your individual waiting period is before you may be a volunteer with a FRS participating location without interrupting your distributions.

We cannot contact FRS on your behalf as they need personal information from you to access your plan. Thank you.

FRS Acknowledgement:

Volunteer Portal

Volunteer Polk provides a volunteer portal for you to view your assignments and status of your application to them, view and edit your personal information, view and export your volunteer service hours, and more!

Please enter a password that:

Is between 6 and 30 characters long

Password:

Confirm password:

Screening Authorization

All the volunteer opportunities associated with this application require various screenings. Some assignments due to their involvement with vulnerable populations will require higher screening levels.

Our office rescreens every 5 years from the initial registration or sooner if deemed necessary. Individual programs may repeat additional screens at another time length.

By selecting "I agree" you allow Volunteer Polk to use your personal information provided on this application to conduct the necessary screens for your placement and have reviewed your preferred assignment qualifications and feel you meet the minimum requirements for placement.

I Agree

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