Volunteer Application

Date

Name *

Information

Address *

City

State/Province

Zip/Postal

Phone *

Birthday (month/day only)

Email Address *

Update by e-mail

Please e-mail me with volunteer/event updates.

Emergency Contact Name / Phone *

Education

Highest degree / date obtained

Area(s) of study

Current or Most Recent Employment

Company / Job Title

Responsibilities

Special Skills and Experience

(Hobbies, foreign language spoken, current professional certifications)

Special Skills and Experience

Volunteer Interest

(What type / length of positions interest you most?)

Type / Length *

Days and times available to volunteer: *

How did you learn about JCCC volunteer opportunities?

References

(Contact name and phone — other than family members)

1. *

2. *

Background Information

Have you ever been employed by Johnson County Community College? *

Yes

Please provide position(s), dates of employment and supervisor. *

Have you ever been convicted of a criminal offense? *

Yes

A conviction will not necessarily bar participation with JCCC's volunteer program, but will be considered within the context of the entire application.

Agreement and Signature

I understand that references listed on this application may be contacted and that depending on the volunteer position, there may be certain qualifications such as background check, driver’s license and MVR verification that I must meet before I begin volunteering. If selected, I agree to abide by all policies, procedures, rules and training applicable to my volunteer position(s).

By submitting this form, I certify that all statements contained here are correct to the best of my knowledge. *

I Agree

This form must be acknowledged by parent / guardian if volunteer is under 18 years of age.

Parent / Guardian name

Parent/Guardian Agreement

I Agree

JCCC Staff

Revised 7/2019