WLRI INCORPORATED | Volunteer Application
Prepared for official use for operational years
VOLUNTEER APPLICATION | CONFIDENTIAL RECORD | NOT FOR PUBLIC VIEW
Contact Information |
Your Legal Name__________________________________________________________________________________________________
Street Address______________________________________________________ P.O. Box (if applicable) ______________________
City, State and Zip+4 Code _________________________________________________________, __________ ____________-______
Home Phone/ Mobile Phone _______________________________________________________________________________________
Work Phone __________________________________ E-Mail ______________________________________________________________
Availability | When are you available for volunteer assignments?
(add a page if more space is needed)
Interests in which areas you are best suited to volunteer?
Special skills or qualifications (attach additional pages as needed)
Skills and qualifications can be acquired through employment, previous volunteer work or other activities (such as hobbies, sports, gaming, public speaking engagements, etc.)
What additional (unrelated) skills or qualifications do you have to contribute?______________________________________________________________________________________________________________________
Previous volunteer experience:______________________________________________________________________________________
(attach additional pages as needed)
Person to notify in the event of a emergency: _____________________________________________Phone__________________
AGREEMENT, CERTIFICATION AND ENDORSEMENT OF AUTHORIZATION
By submitting this application, I affirm that the facts set forth are true and complete. I understand that if I am accepted as a volunteer any false statements, omissions or other misrepresentations made by me on this application may result in my immediate dismissal and that all decisions by management are final.
WLRI FORM 2019A
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This form was electronically generated for public use on WLRI.org or MyWLRI.com and must be printed and mailed to: WLRI Incorporated, P.O. Box 10, Bart, PA 17503-0010 for its consideration, processing and administration in any official capacity. DO NOT EMAIL, CUT AND PASTE or ALTER THIS FORM IN ANYWAY.
If you need help or would like an application mailed to you, please contact us to request one at no charge.