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County Volunteer Application Form

Date:

Full name of applicant:

Street Address:

City/Town:

Postal Code:

Phone Number(s):

Email Address:

What area(s) are you interested in volunteering with?

Food 4 All Warehouse

Golden Plough Lodge Long Term Care Home

Northumberland County Archives and Museum

Northumberland County Forest

Why are you interested in volunteering with Northumberland County?

Please list any current and past volunteer experience:

Organization Name:

Position

Dates (from/to)

Organization Name:

Position

Dates (from/to)

Organization Name:

Position

Dates (from/to)

Briefly outline any paid or volunteer experience that may relate to volunteering with Northumberland County.

Briefly outline any formal education or training that may relate to volunteering with Northumberland County.

I can offer my services:

Daily

Weekly

Monthly

I am pleased to provide the following references (other than family):

Name:

Organization:

Phone Number:

Relationship to applicant:

Name:

Organization:

Phone Number:

Relationship to applicant:

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