CASDA Volunteer Application

Desired Position *

Volunteer

Intern

Name *

Pronouns

Address *

Phone Number *

Email Address *

Preferred Method of Communication *

Phone

E-mail

Are you over the age of 18? *

Yes

No

Availability (Our highest need is during regular business hours: 8 a.m. - 4 p.m. and weekend opportunities are usually limited to on-call and special event positions.)

	Availability
Monday	Availability
Tuesday	Availability
Wednesday	Availability
Thursday	Availability
Friday	Availability
Saturday	Availability
Sunday	Availability

Anything else we should know about your availability? (Date available to begin, # of hours or days per week desired, etc.)

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/Intern Area(s) of interest (i.e. Office, Childcare, Legal, Outreach, Special Events, etc.) *

Have you received a position description for you 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

	Fill
Employer Name	Fill
Dates of Employment	Fill
Address	Fill
Phone Number	Fill
Job Title & Description of Duties	Fill
Supervisor Name	Fill

May we contact this person

Yes

No

Volunteer

	Fill
Organization Name	Fill
Duties Performed	Fill
Dates of Service	Fill
Supervisor Contact Info	Fill

REFERENCES

Reference #1 *

	Fill
Name	Fill
Phone Number	Fill
Email	Fill

Reference #2 *

	Fill
Name	Fill
Phone Number	Fill
Email	Fill

Reference #3

	Fill
Name	Fill
Phone Number	Fill
Email	Fill

If service is required for school

	Fill
School/Program Name	Fill
Instructor Name	Fill
Number of Hours Required	Fill
Date for Completion	Fill

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.

Date * +

Applicant's Signature *

clear

INTERN ONLY* Cover Letter

INTERN ONLY* Resume