Veteransoutreachcenter.org

ABOUT

Name *
Street Address *
City, State, Zip *
Home Phone
Work Phone
Cell Phone
Email Address *
Are you a U.S. citizen *	Yes No
Have you ever served in the military	Yes No
If yes please indicate Branch and Date of service
During Which Hours are you available? *	Weekdays Weekends
What Are Your Interests *	Administrative Support Driver (provide copy of NYSDL) Fundraising & Events Instructor (computer/technology/health..) Maintenance (painting, lawn etc.) Outreach Events Veteran Mentor Retail Support Welcome Center Greeter OTHER
Qualifications (Please attach resume if available)
Qualifications (If you don't have a resume)
Have you ever worked at Veterans Outreach Center *	Yes No
Do you have a valid NYS Drivers License *	Yes No
Are you currently employed *	Yes No
Do you have physical limitations *	Yes No
Have you ever been convicted of a crime *	Yes No
If yes, please explain:
Have you ever been convicted of child abuse *	Yes No
Have you ever been disciplined/censured by a professional organization *	Yes No
Person to Notify in Case of Emergency *
Relationship
Street Address
City State Zip
Home Phone *
Cell Phone
Email
It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age or disability *
By submitting this application, I affirm that the facts set forth in it 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 *	I Agree I Disagree

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