Name
Address
City
State/ZipCode
Phone
Email
Why are you interested in Volunteering
Area of Interest
I am interested in serving on a Committee Of the Board of Directors
Authorization & Agreement By Applicant by completing this interst form you certify and agree to the following
I certify that the facts set for in this board committee/volunteer interest form are true and complete to the best of my knowledge. I understand that any false statement, omission or misrepresentation in my volunteer interest may result in the rejection of my volunteering at the Florence Douglas Center volunteer program.
I consent to having Florence Douglas Senior Center complete a criminal background check prior to volunteering.