Volunteer

Name

Full Address

Phone

Email

Why are you interested in Her Nexx Chapter?

What would you like to accomplish for yourself through HNC?

In which area would you like to volunteer?

What experience do you have in this area?

In which of these areas are you experienced?

How many hours a week can you volunteer?

Have you performed community service in the past? If yes, what were your responsibilities and for what organization?

Where was this organization located?

Highest level of education

Current employer

Emergency contact name

Relationship

Phone

All applicants must answer the following question. Failure to answer honestly will disqualify the applicant from service as a volunteer with our organization. Have you ever been convicted of a felony?

Yes

No

If yes, describe the conviction below. Please include the date of the crime and city, county and state where the crime took place.

By signing below you agree that all information you have provided in this application is true to the best of your knowledge. Sign:

Date:

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We appreciate your interest in getting involved with our cause. We’re currently accepting applications for volunteer positions. Please complete the Volunteer Form below and we will contact you.

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