Convergence Resource Center | www.convergenceresource.org

Volunteer Application Form

First name

Last name

Phone

Birth Date required

Ethnic Background

Social Security Number

Street Address

City

Postal / Zip code

Street Address Line 2

State

Please describe your volunteer areas of interest and reasons for applying.

Have you ever been convicted and/or prosecuted for any felonies or misdemeanors? If yes, briefly describe

Are you a member of any organized religious groups? If yes, please list names.

Do you have any previous volunteer experience? If so, where and what were your responsibilities?

Please list your educational background, as well as any certifications, diplomas and/or training.

I agree that all information provided is true to the best of my knowledge. I agree that this position is non-paid and I am volunteering at my own will.

Note: Submitting this application gives consent for a criminal background check

Thanks for applying to volunteer with us! We'll get back to you soon.