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Volunteer Application

Date of Application: * / MM / DD YYYY
Name * First Last
Contact Information:
Home Phone: * - (###) - ### ####
Cell: - (###) - ### ####
Email: *
Please check the kind of work you are most interested in doing: * Program Support (administrative coordination, computer skills, internet research) Community Outreach (Event planning and production) Marketing and Public Relations (multi-media) Translating, Language Skills Other
I am particularly interested in volunteering for the following Ecology Action events: Earth Day (Spring) Bike Week (Spring/Fall) Bike-to-Work/School Days (Spring/Fall) Annual Community Beach Clean-Up (Fall) Promotional Events (Ongoing) Local Campus Outreach (Ongoing) Bike Smart! (Ongoing) Boltage Program (Ongoing) Walking School Bus Leader (Ongoing)
Please note any related hobbies, or interests.

Activity Organization Dates
Please note computer applications with which you have experience: Word Excel Powerpoint Databases Computer Graphics Social Media Facebook Web Development Other
Please describe any relevant volunteer or professional experience.
Availability:
Date available to start: * / MM / DD YYYY
Preferred Days of Week: * Mon Tues Wed Thurs Fri Sat Sun
Preferred # of hours per week: *
Preferred Time of Day: *
Are you volunteering as part of any assigned community work program? * Yes No
Are you a student? * Yes No
If you are a student, are you: Full Time Part Time
Are you interested in an internship for academic credit? * Yes No
If so, what is your deadline to apply? / MM / DD YYYY
Are you under 18 Years of Age? * Yes No
Parental approval required if under 18
Privacy statement: Ecology Action does not share your personal information with any other entity. This information is to be used for internal placement use only, and will be handled with complete confidentiality.

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