"Volunteer Application Form" - City of Newport, Oregon

Volunteer Application Form is a legal document that was released by the Police Department - City of Newport, Oregon - a government authority operating within Oregon. The form may be used strictly within City of Newport.

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Newport Police Department
VOLUNTEER APPLICATION
(Print or type all information)
APPLICANT INFORMATION
Last Name
First
Middle
Street Address
Apartment/Unit #
Mailing
City
State
ZIP
Home Phone
Cell Phone
Driver License/ID #
State
Email Address
Are you a citizen of the United States? YES ☐
NO ☐
Have you ever been convicted of a crime? YES ☐
NO ☐
If yes, explain
Are you at least 18 years of age?
YES ☐
NO ☐
If yes, explain
What specific job-related skills do you possess?
COMPUTER ☐
DATA ENTRY ☐
ORGANIZATIONAL ☐
OTHER ☐ (Explain)
What days and times are you available to volunteer?
How many hours can you volunteer per week? (circle)
2 to 4
5 to 10
11 to 15
16 +
EDUCATION
High School
Address
Did you graduate? YES ☐
NO ☐
Degree
College
Address
Did you graduate? YES ☐
NO ☐
Degree
Other
Address
Did you complete certification? YES ☐
NO ☐
Certificate
PERSONAL REFERENCES
List only persons you have known for more than six (6) months. DO NOT list relatives or former employers.
Full Name
Address
City, State, Zip
Phone
(
)
Full Name
Address
City, State, Zip
Phone
(
)
Full Name
Address
City, State, Zip
Phone
(
)
Newport Police Department
VOLUNTEER APPLICATION
(Print or type all information)
APPLICANT INFORMATION
Last Name
First
Middle
Street Address
Apartment/Unit #
Mailing
City
State
ZIP
Home Phone
Cell Phone
Driver License/ID #
State
Email Address
Are you a citizen of the United States? YES ☐
NO ☐
Have you ever been convicted of a crime? YES ☐
NO ☐
If yes, explain
Are you at least 18 years of age?
YES ☐
NO ☐
If yes, explain
What specific job-related skills do you possess?
COMPUTER ☐
DATA ENTRY ☐
ORGANIZATIONAL ☐
OTHER ☐ (Explain)
What days and times are you available to volunteer?
How many hours can you volunteer per week? (circle)
2 to 4
5 to 10
11 to 15
16 +
EDUCATION
High School
Address
Did you graduate? YES ☐
NO ☐
Degree
College
Address
Did you graduate? YES ☐
NO ☐
Degree
Other
Address
Did you complete certification? YES ☐
NO ☐
Certificate
PERSONAL REFERENCES
List only persons you have known for more than six (6) months. DO NOT list relatives or former employers.
Full Name
Address
City, State, Zip
Phone
(
)
Full Name
Address
City, State, Zip
Phone
(
)
Full Name
Address
City, State, Zip
Phone
(
)
EMPLOYMENT HISTORY
Company
Phone
(
)
Address
Supervisor
Job Title
Responsibilities
From
To
Reason for Leaving
Company
Phone
(
)
Address
Supervisor
Job Title
Responsibilities
$
From
To
Reason for Leaving
Ending Salary $
Company
Phone
(
)
Address
Supervisor
Job Title
Responsibilities
$
From
To
Reason for Leaving
Ending Salary $
AGREEMENT and SIGNATURE
I understand that I may be required to verify any and all information given on this application.
I certify that all the information provided in this application is true and accurate and I have not withheld any information relative to my application. I understand that
any misrepresentation or omission, as well as any misleading statements or omissions of application information, attachments, or supporting documents may result in
denial of volunteering, or immediate termination of a volunteer assignment.
I understand that an in-depth background check may be conducted prior to volunteering with City of Newport. This may include, but is not limited to, a Criminal
History check, a DMV check, education and certification verification, or credit check in order to determine suitability for volunteering. (You will be contacted again if an
in-depth background check is utilized.)
I authorize representatives of City of Newport to contact the employers and references listed in this application (or otherwise provided by me), and any other person
Have you ever been convicted of any type of crime involving domestic violance? YES ☐
NO ☐
as developed through these contacts in order to determine my suitability for volunteering. I understand that as the process progresses I may be required to provide
additional information in order that a thorough background check can be completed. I understand and agree that, if assigned to a volunteer position, my volunteer
relationship with City of Newport, Police Department is for no definite period and the relationship may be terminated at any time and without prior notice by either
party.
Name (printed)_________________________________________________________________________________________________________________________
Signature ______________________________________________________________________________________ Date __________________________________
OUR POLICY
It is the policy of the City of Newport to fill volunteer vacancies with the most qualified individuals. Volunteer applicants will be considered on an equal basis without
regard to age, race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected under state, federal, or local
law.
Thank you for completing this application form and for your interest in volunteering with us!
ADDITIONAL EXPERIENCE AND SKILLS
List your prior experience working with:
☐ Diverse Communities
☐ Media
☐ Other Law Enforcement
☐ Other Volunteer Groups
Which groups?
☐ Youth & Youth Issues
☐ Interpreting Research Data
☐ Other training received, i.e. First Aid, CPR, Computer Skills, Photography
Explain
Have you been a Volunteer:
☐ Reserve Officer
☐ Auxiliary Officer
☐ Firefighter
☐ Chaplain
If YES, where?
Please indicate which of the following you may assist with or are primarily interested in:
☐ Animal Care/Rescue
☐ Bilingual Interpreter
☐ Clerical
☐ Citizen Patrol
☐ Data Entry
☐ Document Filing
☐ Document Scanning
☐ Ham Radio
☐ Social Media
☐ Disaster Response
☐ Driver/List Class
☐ Graffiti Abatement
☐ Neighborhood Watch
☐ Search & Rescue
☐ Speakers Bureau
☐ Vehicle Maintenance
☐ Special Events
☐ Translations
☐ Photography
☐ Assist With Cold Case Follow-ups
☐ Traffic Control/Monitoring/
Hazards
☐ Other (explain)
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