Volunteer Application Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Home PhoneCell PhoneWork PhonePlease list two references:*NameAddressPhoneRelationship Are you able to commit to the following?Being a volunteer for at least one year?* Yes No Being available for monthly shifts?* Yes No Attending monthly meetings [CIC only]?* Yes No Turning in required paperwork and documentation?* Yes No Seeking out supervision?* Yes No Applicant InformationCheck One* At least 18 yrs old at time of training? [CIC & Direct Service Volunteers] At least 16 years old at time of training? [Program Support Volunteers] How did you learn about our agency and/or about our volunteer program?*Why are you interested in becoming a volunteer with The Laurel Center?*Please list any previous or current community service work (paid or volunteer).*What types of volunteer work are you interested in providing?*CAPTCHA Δ
