Education
Elementary School:	5 6 7 8	Where?		College:	0 1 2 3 4	Where?
High:   School:	0 1 2 3 4	Where?		Graduate:	0 1 2 3 4	Where?

Previous work experience:
Are you presently employed?	yes no	If yes, how many hours worked per week?
Where do you work?
Special skills, training, interests or hobbies:
Previous volunteer jobs:
What kind of volunteer opportunities are you interested in?
What are your volunteer goals?
What time do you have available?
Total hours per week available:
Days available (Mon,Tues,Wed,Thurs,Fri,Sat,Sun):		Days not available:
Preferred hours:		Preferred Days:
Available from:		Available to:
Please give us any further information or comments you might wish to offer:
SKILLS & INTERESTS

Please Check your skills and interests	Very well	Well	So-so	Not at all	Comment
Computer skills: Microsoft Word (wpm___), PageMaker, Quark, Photo Shop, Excel, CADD, PowerPoint, database, graphics design, Web design, other:
Office skills: filing, phones, records, organizing, minute taking:
Speaking: public, express ideas, sell & influence:
Teaching & training:
Use statistics & numbers: bookkeeping, accounting (10-key pad), collecting & analyzing figures, computing & estimating:
Writing: grants, reports, articles:
Working with: children, juveniles, elderly, mentally ill:
Taking responsibility, making decisions:
Meeting new people:
Good with your hands: machines, equipment, crafts:
Artistic Skills: drawing, painting, photography:
Outdoors, hiking:
Reading:
Other languages (speak, read, write):
Other (please list):

EMERGENCY INFORMATION
VOLUNTEER Name:
VOLUNTEER Address:
VOLUNTEER Home and work phone numbers:

Please list two people (relatives, friends, neighbors) who can be contacted in case of emergency:

	Name	Relationship	Home phone	Work phone	Cell phone/pager
1
2

Information accurate as of 
When information changes, please contact Civic Center Volunteers.