THINK Together Community Volunteer Application

First Name 
 

Middle Name 
 

Last Name 
 

Address 
 

City 
 
State 
  Zip Code 
 

Home Phone 
 
Work Phone

Best time to contact you 
 

Email Address

Gender 
 

Date of Birth (MM/DD/YYYY)      /      /     

If you are affiliated with a group that will be attending the Event, please indicate which one in the box.

Please Indicate the times you will be available to volunteer on March 25, 2009. Keep in mind that set up begins at 8am and clean up will ends at 7:00pm.

Set Up 8am – 2:00pm  
 
During Event 2pm – 5pm 
 
Clean Up 4pm-7pm  
 
Other?      
 

Emergency Contact Information:


Name 
 
Address 
 

Telephone 
 
Relationship 
 

Do you have any special needs to be able to volunteer? 
 

Have you ever been accused, arrested, or convicted for any sexually related crimes? 
 

Have you ever been convicted of a felony? 
 

APPLICANT'S STATEMENT
The information contained in this application is correct to the best of my knowledge. I authorize any references or organizations listed in this application to give you any information they may have regarding my character and fitness working with children, and I release all such references from liability for any damage that may result from furnishing such evaluations to you. I understand that any personal information will be held in strict confidence.

I also agree to hold harmless THINK Together, it's partners, their boards and commissions, and their officers, agents, and employees from and against all claims, loss, or liability of any kind or nature for any possible injury incurred during volunteer service.