CASDA Volunteer Application

DESIRED POSITION * 🛈

Volunteer

Intern (Please see additional instructions.)

NAME *

STREET ADDRESS, CITY, STATE, ZIP * 🛈

PHONE NUMBER(S) - area code first * 🛈

E-MAIL ADDRESS

PREFERRED METHOD OF COMMUNICATION *

Phone

E-mail

ARE YOU OVER AGE 18? *

Yes

No

MONDAY AVAILABILITY (Our highest need is during regular business hours: 8 a.m. - 4 p.m.)

TUESDAY AVAILABILITY (Our highest need is during regular business hours: 8 a.m. - 4 p.m.)

WEDNESDAY AVAILABILITY (Our highest need is during regular business hours: 8 a.m. - 4 p.m.)

THURSDAY AVAILABILITY (Our highest need is during regular business hours: 8 a.m. - 4 p.m.)

FRIDAY AVAILABILITY (Our highest need is during regular business hours: 8 a.m. - 4 p.m.)

SATURDAY AVAILABILITY (Weekend opportunities are usually limited to on-call and special event positions.)

SUNDAY AVAILABILITY (Weekend opportunities are usually limited to on-call and special event positions.)

ANYTHING ELSE WE SHOULD KNOW ABOUT YOUR AVAILABILITY? (Date available to begin, # of hours or days per week desired, etc.)

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FOR WHAT LENGTH OF TIME COULD YOU COMMIT TO THIS VOLUNTEER OPPORTUNITY? * 🛈

BACKGROUND

DO YOU HAVE A VALID DRIVER'S LICENSE? *

Yes

No

IF YES, PLEASE INDICATE STATE OF ISSUE

DO YOU HAVE CAR INSURANCE? * 🛈

Yes

No

VOLUNTEER AREA(S) OF INTEREST (i.e. Office, Childcare, Legal, Outreach, Special Events, etc.) or INTERN POSITION(S) or SPECIFIC SPECIAL EVENT for which you plan to volunteer *

HAVE YOU RECEIVED A POSITION DESCRIPTION FOR YOUR VOLUNTEER AREA(S) OF INTEREST? *

Yes

No

IF YES, PLEASE EXPLAIN ANYTHING THAT WOULD PREVENT YOU FROM PERFORMING THE ACTIVITIES INVOLVED IN A REASONABLE AND SAFE MANNER.

EMPLOYMENT HISTORY & VOLUNTEER EXPERIENCE

EMPLOYER NAME (current or most recent)

DATES OF EMPLOYMENT

ADDRESS

PHONE NUMBER

JOB TITLE & DESCRIPTION OF DUTIES

SUPERVISOR NAME

MAY WE CONTACT THIS PERSON?

Yes

No

PLEASE DESCRIBE ANY PAST VOLUNTEER EXPERIENCE. INCLUDE ORGANIZATION NAME, DUTIES PERFORMED, DATES OF SERVICE & SUPERVISOR CONTACT INFO.

REFERENCES

1. NAME * 🛈

PHONE NUMBER *

E-MAIL *

2. NAME * 🛈

PHONE NUMBER *

E-MAIL *

3. NAME 🛈

PHONE NUMBER

E-MAIL

IF SERVICE IS REQUIRED FOR SCHOOL, PLEASE INDICATE SCHOOL/PROGRAM NAME, INSTRUCTOR NAME, NUMBER OF HOURS REQUIRED & DATE FOR COMPLETION.

WHY WOULD YOU LIKE TO VOLUNTEER/INTERN FOR CASDA? *

HOW DID YOU HEAR ABOUT THIS OPPORTUNITY? *

PLEASE READ VERY CAREFULLY BEFORE SIGNING BELOW.

I understand and voluntarily agree that:

The information that I have provided on this application is true and complete to the best of my knowledge. Any misrepresentation or omission of any fact in my application, resume, or any other materials, or during any interviews, can be justification for refusal of volunteering, or, if a volunteer, termination from CASDA.
CASDA is not obligated to place me in a volunteer position.
In processing my application for a possible volunteer position, CASDA may verify all the information provided by me through an investigative consumer report concerning, among other things, my prior employment or military record, education, character, general reputation, personal characteristics, criminal record and mode of living. I understand that upon written request I will be informed whether an investigative consumer report was requested and given full information as to the nature and scope of this investigation.
I authorize and request that my present and former employers and those individuals I have listed as personal references furnish information about my employment record, including a statement of the reason for the termination of my employment, work performance, abilities, and other qualities pertinent to my qualifications for volunteering. I hereby release them from any and all liability for damages arising from furnishing the requested information.

SIGNATURE & DATE *