Newaygo County Council for the Arts

E-mail artsplace@riverview.net

Phone: 231.924.4022 Fax: 231.924.5591

Volunteer Application Form

PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE



					DATE ________________________________
Name __________________________________________________________________________________________
Last First Middle Maiden
Present address __________________________________________________________________________________
Number Street City State Zip
How long ___________________
Telephone ( )
			Days/hours available volunteer No Pref _______ Thur _________ Mon __________ Fri __________ Tue __________ Sat _________ Wed _________ Sun _________
Can you volunteer nights? __________________________________


________________________________________________________________________________________________

TYPE OF SCHOOL	NAME OF SCHOOL	LOCATION		NUMBER OF YEARS COMPLETED		MAJOR & DEGREE
High School

College/University

Bus. or Trade School

Professional School
Other Professional School

HAVE YOU EVER BEEN CONVICTED OF A CRIME? q No q Yes
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation. _______________________________________________

	PLEASE PRINT ALL INFORMATION REQUESTED EXCEPT SIGNATURE

	Please list two references other than relatives or previous employers.
	Name ______________________________________		Name _________________________________________
	Position _____________________________________		Position _______________________________________
	Company ___________________________________		Company ______________________________________
	Address ____________________________________		Address _______________________________________
	_____________________________________		_______________________________________
	Telephone ( )		Telephone ( )


	Work or Volunteer Experience	Please list your work or volunteer experience.

	Name Address		Name of last supervisor	Dates
	City, State, Zip Code Phone number			From To
	List the jobs you held, duties performed, or skills used or learned.





	Name Address		Name of last supervisor	Dates
	City, State, Zip Code Phone number			From To
	List the jobs you held, duties performed, skills used or learned.




Thank you for completing this application form and for your interest in our organization.
	Newaygo County Council for the Arts (NCCA) 13 E. Main Street Fremont, MI 49412 231-924-4022