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2. York County Volunteer Services Application
   Thank you for your interest in volunteering your time and talent! Knowing a little bit about you will help us identify the most appropriate and comfortable volunteer experience for your, so please fill out this form as completely and accurately as possible.
4. Full Name:
6. Street Address:
8. City:
9. State:
10. Zip Code:
12. Email Address:
13. Home Phone:
15. Work Phone:
16. Cell Phone:
18. Days of the week/month you would be available:
20. Hours you would be available:
22. Do you have have your own transportation?

    1. Yes
    2. No
24. Special interests, Skills, and Hobbies:
26. With whom and where would you like to work? (Check all that apply)

    1. Preschool
    2. Elementary School
    3. Middle School
    4. High School

    1. Adults
    2. Senior Citizens
    3. Groups

    1. One-on-One
    2. With the Public
    3. Alone

    1. Outdoors
    2. Indoors
    3. Office
28. Signature or Signature of Parent/Guardian*
29. Date*
    Date
31. Supplemental Information
33. Are you presently a student?*

    1. Yes
    2. No
34. If so, Where?
36. Do you wish to receive credit for your volunteer hours?

    1. Yes
    2. No
37. Number of hours you are carrying:
39. High School:
41. Highest Grade Completed:
    -- Select One --89101112GED
43. College:
45. Technical School:
47. Major Coursework:
49. Please list two personal references:
    Name, Address, Phone - not relatives
51. Emergency Contact
53. Name:
54. Relationship:
56. Street Address:
58. City:
59. State:
60. Zip Code:
62. Cell Phone:
63. Work Phone:
64. Home:
66. Personal Physician:
67. Phone:
69. How did you learn about out volunteer program?
Leave This Blank:


71. 1. Receive an email copy of this form.
72. Email address

    This field is not part of the form submission.

73. Submit

* indicates a required field