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Volunteer Form
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Steps
1.
Personal Information
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2.
Education / Related Interest
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3.
Experience
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4.
Personal References
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Personal Information
What type of volunteer are you applying for
*
Citizen Volunteer
Chaplain Volunteer
A current and valid ordination or license is required. Can you provide a copy of your credentials?
*
Yes
No
If no, why?
Personal Information
Name
*
Date Of Birth
*
Date Of Birth
Address
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City
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State
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Zip Code
*
Preferred Phone
*
Cell
Home
Phone
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Drivers License Number
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State
*
-- Select One --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Massachusetts
Maryland
Michigan
Minnesota
Mississippi
Missouri
Montana
North Carolina
North Dakota
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
West Virginia
Wisconsin
Wyoming
Washington D.C.
Emergency Contact
Name
*
Phone
*
Address
*
City
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State
*
-- Select One --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Massachusetts
Maryland
Michigan
Minnesota
Mississippi
Missouri
Montana
North Carolina
North Dakota
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
West Virginia
Wisconsin
Wyoming
Washington D.C.
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Education / Related Interest
Pertinent Skills
*
Computers
Filing
Research
Typing
Writing
Other
If other, please explain
High school graduate or equivalent?
*
Yes
No
College graduate or current enrollment
*
Yes
No
Last school or college attended
*
Major
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Experience
Company / Organization
*
Date of Employment
*
Date of Employment
Supervisor
*
Company / Organization
*
Date of Employment
*
Date of Employment
Supervisor
*
Company/ Organization
*
Date of Employment
*
Date of Employment
Supervisor
*
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Personal References
Name
*
Years Acquainted
*
Address
*
Phone
*
Email (required):
*
Name
*
Years Acquainted
*
Address
*
Phone
*
Email (required):
*
Name
*
Years Acquainted
*
Address
*
Phone
*
Email (required):
*
General Release of Liability
For and in consideration of the granting of permission to participate in the activities conducted by and/or with City personnel, in my volunteer status, the undersigned, on behalf of him/herself, his/her heirs, executors, administrators, and assigns, hereby fully releases and discharges City of Fontana, its members, agents, and employees from any and all claims, actions and liabilities that may arise as a result of my volunteer participation with the Police Department / Division.
The undersigned has read this General Release of Liability and fully understands and acknowledges the significance of said General Release of Liability and hereby assumes full responsibility for any injuries, damages, or losses that he/she may incur from my volunteer participation with the City.
As a Volunteer, I understand that I am not entitled to receive compensation or benefits of any kind from the City, except those afforded in accordance with CA Workers’ Compensation laws.
I further understand that should I use my automobile in Volunteer Service, I will keep in effect, automobile liability insurance equal at least to the minimum limits required by the State of California.
Dated
*
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Name of Participant
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Email Address
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