Personal Information

Last Name *

First Name *

Street Address*

City, State Zip*

Home Phone*

Work/Cell

Email

Sex
Female   Male

Ethnicity

Date of Birth

Education / Experience

Employed
Yes   No

Place of Employment

Name of Most Current School Attended

Indicate Highest Degree Completed

Language(s) Spoken Fluently

Prior Volunteer or Social Service Experience

Activities (Civic, Athletic, etc.)

Volunteer Interests

Programs / Services of Interest

Children’s Activities ¤
Homeless Women
Legal Services

Homeless Families ¤
Resale Shop
Other:

TB Test and Fingerprint clearance required

Why do you want to volunteer at the YWCA of San Diego County?

Advertising

How did you hear about the YWCA of San Diego County?

Brochure/Newsletter
Campus
Event
Friend

Internet
Newspaper
TV/Radio
Other

Eligibility

Professional References: List two adults who you have known professionally
for at least one year.

Name

Phone

Email

Fax

Name

Phone

Email

Fax

Have you ever been convicted of a crime other than a minor traffic violation?
Yes   No

If yes, please explain the nature of the crime(s), and when and where convicted:

All opportunities have a minimum age requirement of 18. Are you 18 or older?
Yes   No

Emergency Contact

Name

Relationship

Phone 1

Phone 2

Volunteer Agreement

This completed application signifies my understanding that this is the first
step in a three-step process. If at any time during this process (which also
includes a personal interview), it is felt by either myself of the YWCA Volunteer
Coordinator that this assignment is not appropriate, I understand that a
consultation will be arranged to determine alternatives.

Please type in the graphic code as you see it
(click graphic if it is not legible)*

Note: Please print this page before submitting so you will have this information
for your records. Thank you.