Volunteer Application

Contact Information

* Name:

* Street Address:

* City:

* State:

* Zip Code:

* Phone Number :

Alternate Phone Number:

Best time to Call:

* Email Address:

* Date of Birth:

Applicant Information

How did you hear about DVSAS?: Website Newspaper Poster Friend Other

Do you have any friends or relatives who are past or present volunteers/staff members? If yes, who?:

Are you interested in applying for an internship position?: Yes No Possibly

Languages you speak in addition to English:

What is your fluency level in any additional languages?: Fluent Intermediate Minimal

Do you have a reliable vehicle and valid driver's license?: Yes No

If you do not have a vehicle, do you have reliable transporation?: Yes No

* Have you ever received services from DVSAS?: Yes No

If yes, when?:

Experience and Education

* Describe any relevant work experience/personal experience/education/training you have had that you feel helps prepare you for being a DVSAS volunteer.:

* Highest Grade Completed: Some High School High School Diploma/GED Some College Associates Degree Bachelor's Degree Postgraduate

Last school attended:

Degree/Program:

Major:

Other Comments: