Volunteer Action Center Application

 

Return to: Student Organization Services

PO Box 6444. SOW Mountainlair

Morgantown, WV 26506-6444

Personal Information

Name:

Address:

City: State: Zip:

E-Mail Address:

Phone: Best Time to Call:

Optional Personal Information

Gender: ___male ___female

Age: ___under 18 ___18-60 ___60+

Organization Information (if applicable)

If you are requesting information on behalf of an organization, please list the name of the organization.

Organization: # of volunteers:

 

 

Previous Volunteer Experience:

 

 

 

 

 

 

Hobbies and Interests:

 

 

 

 

 

 

Current Full Time Employment (if applicable)

Company:

Title:

Address:

City: State: Zip:

Phone: Best Time to Call:

Education/Training

Please list any education or training you have received (or are currently receiving). Include institution, field of study and degree.

 

 

 

 

 

Service Areas

Please indicate which service areas are of specific interest to you. Check all that apply:

___Assist Elderly

___HIV/AIDS

___Arts and Culture

___Community & Economic Development

___Domestic Violence & Rape

___Emergency Services & Natural Disasters

___Health & Rehabilitation

___Homeless & Hungry

___Job, Career Development, & Skills Training

___Literacy

___Mentoring

___Natural Resources, Conservation, Preservation

___At Risk Youth

___Substance Abuse

Other: