Volunteer Application Form

 

     Please fill out this application, supplying all required information. Applicants are strongly encouraged to provide all optional information as well. When you are finished, click the "Submit Application" button at the bottom of the page. Your application will then be sent to Kerry McCoun, Patron Services Manager, Salt Lake County Center for the Arts.

     Note that by submitting this application, you authorize Salt Lake County to perform, e.g., reference checks, employment verification, etc., of any and all information of whatever kind in either written or verbal form which relates to your ability to perform the duties of the position for which you are applying. You also release Salt Lake County of any liability for the use of this information in considering and reviewing your application.

*

Denotes a required field
* Name:
First Last
* Birthdate: / /
Month Day Year
* Address:
Zip
Street City State
* Phone: ( ) - ( ) -
Home Work
Email:
*

How did you hear about this County Volunteer Program?
*

Why do you want to work in our program?
*

What experiences have you had to prepare you to work as a volunteer in this program?
* Are you presently a student?
Yes No
Where?
* Current employer:
* Employer address:
Zip
Street City State
* Employer phone: ( ) -
* Time with employer (or unemployed)
Years Months
* Would you like us to keep your current employer abreast of your volunteer service?
Yes No
Previous work experience: (Include time spent with each employer)
* Do you have your own transportation? *
How will you travel?
Yes No
* Do you have vehicle liability insurance? *
Agent:
Yes No
* Do you have a valid driver's license? * Driver's License:
Number
Yes No State
* Please list three professional and/or personal references who know you well and can attest to
your character, skill and dependability: (Do not include relatives)
1.
( ) -
2.
( ) -
3.
( ) -
*Phone
*Name Street City State Zip
* Emergency contact:
Relationship
*Name
( ) -
*Phone
Street City State Zip

By submitting this application, I certify that all statements made in this application are true and complete, and that any misstatement or omission of material facts may subject me to disqualification or dismissal.

 

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