Volunteer Polk, A Program of the Polk County Bd of County Commissioners, Florida Volunteer Application Form - Polk County Board of County Commissioners

Volunteer Application Form - Polk County Board of County Commissioners

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 volunteerpolk@polk-county.net 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!

Name and address

If you have questions about the process, please call Volunteer Polk offices at(863)534-5580.

If you are interested in an internship, in addition to submitting your volunteer application, please e-mail a copy of your resume to volunteerpolk@polk-county.net.

First name:

Last name:

Middle name:

Title:

Nickname:

Street 1:

Street 2:

City:

State:

* Zip: *

Home phone:

Work phone:

Cell phone:

Fax phone:

Other phone:

Email address:

Education:

Emergency Contact

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

First name:

Last name:

Middle name:

Nickname:

Home phone:

Work phone:

Cell phone:

Email address:

Relationship:

Demographic Information

You may optionally provide the following information. It is used only to help get a better idea of the demographic make-up of our volunteers and for possible qualification of occasional grant funding. Again, you are not required to fill in anything within the demographic section.

Gender:

Ethnicity:

Volunteer Polk periodically participates in the application of grant funds and other reporting and are asked to provide the demographics (age, sex, ethnicity, etc.) of our volunteers. We have provided the space here for individuals who choose to provide this information. This data has no bearing on your volunteer placement. (optional)

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.

Assignment Preferences

View volunteer opportunities posted on www.polk-county.net/volunteerpolk. List Board of County Commissioners' volunteer assignments of interest below, in order of preference (only need to list up to first 3 choices).

Background Screening

Some assignments due to their involvement with vulnerable populations, will require higher levels of background screens than others. You will be notified by Volunteer Polk if fingerprinting or additional steps are needed.

Date of birth:

FL Drivers License:

End Agreement

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 background screens for your placement.

Authorization of Background Screens

As stated above, 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 background screens for your placement.

I Agree