Volunteer Application & Services Agreement

Contact Information

Name of volunteer or group leader *

Age, if individual

Are you a US citizen

Position

PPHA Supervisor

Email Address

Home Phone

Mobile Phone

Street Address *

City *

State *

Zip *

Driver's License

PPHA Associate must verify that the volunteer is in possession of one of these documents

If Volunteer Is Under Age 18

Name of Parent/Guardian

Home Phone

Mobile Phone

Email Address

Street Address

City

State

Zip

Start Date

End Date

Confirmation

Yes

I affirm that I am the parent/guardian of the above named volunteer. I understand that the association volunteer program does not provide compensation, except as otherwise provided by law. I have read the attached description of the service that the volunteer will perform. I give my permission for the applicant to participate in the specified volunteer activity sponsored by Pompeys Pillar Historical Association at Pompeys Pillar National Monument between the dates specified above. Choosing "Yes" is an official signature of confirmation and acceptance of the outlined protocols.

Emergency Contact Information

Name/Relationship to Applicant

Home Phone

Mobile Phone

Email Address

Street Address

City

State

Zip

References (3 required)

Full Name

Phone

Full Name

Phone

Full Name

Phone

Availability

During which hours are you available for volunteer assignments?

Weekday mornings

Weekday afternoons

Weekend mornings

Weekend afternoons

Other (please specify below)

Other

Previous Volunteer Experience

Please summarize your previous volunteer experience

Interests

Special Skills or Qualifications

Summarize special skills and qualifications you have

May have been acquired from employment, previous volunteer work or through other activities, hobbies or sports.

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