"Southeastern Veterans' Center Volunteer Application Form" - Pennsylvania

Southeastern Veterans' Center Volunteer Application Form is a legal document that was released by the Pennsylvania Department of Military and Veterans Affairs - a government authority operating within Pennsylvania.

Form Details:

  • Released on January 26, 2007;
  • The latest edition currently provided by the Pennsylvania Department of Military and Veterans Affairs;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Pennsylvania Department of Military and Veterans Affairs.

ADVERTISEMENT
ADVERTISEMENT

Download "Southeastern Veterans' Center Volunteer Application Form" - Pennsylvania

Download PDF

Fill PDF online

Rate (4.7 / 5) 19 votes
SOUTHEASTERN VETERANS' CENTER
ONE VETERANS DRIVE, SPRING CITY, PA 19475-1230
VOLUNTEER APPLICATION FORM
rev 1/26/07
NAME:
ADDRESS:
DATE OF BIRTH:
PHONE NUMBER:
SOCIAL SECURITY NUMBER:
EMAIL ADDRESS:
EMERGENCY CONTACT NAME:
EMERGENCY CONTACT PHONE:
ORGANIZATION AFFILIATION (IF ANY):
EXPERIENCE, TRAINING, OR SKILLS:
HEALTH CARE OR PHYSICAL LIMITATIONS/RESTRICTIONS (IF ANY):
DO YOU HAVE ANY CRIMINAL CONVICTIONS? (IF YES, PLEASE EXPLAIN)
Please fill out and deliver or mail this form to the Volunteer Coordinator at the address above
SOUTHEASTERN VETERANS' CENTER
ONE VETERANS DRIVE, SPRING CITY, PA 19475-1230
VOLUNTEER APPLICATION FORM
rev 1/26/07
NAME:
ADDRESS:
DATE OF BIRTH:
PHONE NUMBER:
SOCIAL SECURITY NUMBER:
EMAIL ADDRESS:
EMERGENCY CONTACT NAME:
EMERGENCY CONTACT PHONE:
ORGANIZATION AFFILIATION (IF ANY):
EXPERIENCE, TRAINING, OR SKILLS:
HEALTH CARE OR PHYSICAL LIMITATIONS/RESTRICTIONS (IF ANY):
DO YOU HAVE ANY CRIMINAL CONVICTIONS? (IF YES, PLEASE EXPLAIN)
Please fill out and deliver or mail this form to the Volunteer Coordinator at the address above
CHARACTER REFERENCES:
NAME
ADDRESS
PHONE
AVAILABILITY:
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
FROM:
FROM:
FROM:
FROM:
FROM:
FROM:
FROM:
TO:
TO:
TO:
TO:
TO:
TO:
TO:
COMMENTS:
,
The information requested is necessary to assist in the recording of your Volunteers Hours for SEVC. Information will
remain confidential. Failure to provide all information will result in our inability to provide you with Volunteer
opportunities at our facility.
,
To the best of my knowledge, the information provided is true and complete. Furthermore, I hereby waive all claims to
monetary benefits or gifts for services rendered as a volunteer.
,
Youth Volunteer Parental Approval:_____________________________________
has my approval and support to
work as a volunteer at the Veterans' Center.
VOLUNTEER SIGNATURE
DATE
PARENT SIGNATURE
DATE
Please fill out and deliver or mail this form to the Volunteer Coordinator at the address above
Page of 2