Form Center

2. Last Name*
3. First Name*
4. Middle Name
6. Email Address*
7. Contact Phone:*
9. Address*
11. City*
12. State*
13. Zip*
15. Are you currently employed?*

    1. Full time

    1. Part time

    1. No
16. Work Phone
18. Current or most recent employer
    If student, list school
20. Position
21. Supervisor's Name
22. Supervisor's Phone
24. Education*
    List high school, college, advanced degrees.
26. Work History
    Provide a brief summary of previous employment.
28. Special Skills
    Indicate any special skills you have or equipment used.
30. Indicate the types of volunteer work in which you are interested.*
32. How often are you available?*

    1. Daily
    2. Weekly

    1. Monthly
    2. Other
33. Other:
35. Check days that you are available*

    1. Monday
    2. Tuesday

    1. Wednesday
    2. Thursday

    1. Friday
    2. Saturday
37. Indicate times of day available*

    1. Morning

    1. Afternoon

    1. Evening
39. Have you ever been convicted of any law violations (including moving traffic violations)?*

    1. Yes

    1. No
41. If you answered "yes" to the above question, please list all and explain. Note that certain minor violations and other offenses will not prevent your acceptance in the volunteer program.
43. How did you hear about this volunteer opportunity?
45. Please list three references:
47. Name
48. Address
49. Phone
51. Name
52. Address
53. Phone
55. Name
56. Address
57. Phone
59. I understand that before I am assigned to a volunteer position with the City of Fredericksburg Department of Social Services, a standard background investigation will be conducted. I hereby authorize such an investigation.
61. The above information is true and correct.
63. Applicant Signature: I understand that checking the box below is the equivalent of signing my name.*

    1. I Accept
65. Applicant Name*
66. Date*
    Date
68. Please indicate your preferred area of interest.*

    1. CPS/APS

    1. FC/Adoptions

    1. Eligibility

    1. VIEW/TANF

    Please note that we try to match volunteers with their area of interest, but can't guarantee they will always be available.
Leave This Blank:


70. 1. Receive an email copy of this form.
71. Email address

    This field is not part of the form submission.

72. Submit Submit and Print

* indicates a required field