Are you at least 16 years of age?  Yes     No

Current Employer:

Phone:             

Elementary School    Middle School    High School

College                    Graduate Studies

How did you hear about Goodwill's Volunteer Program?

Internet    Friend    Community Organization

Other: 

Why do you wish to volunteer?

Are you volunteering to fulfill a commitment?  Yes    No

If yes, please specify below:

Required School Hours (high school)

Required School Hours (college)

Court Ordered    Food Stamps    Other:

Have you ever been convicted of, or pled guilty, no contest or nolo contendere to a crime?  Yes    No

Have you ever been charged with a crime and either been placed on a court-ordered probation, had adjudication withheld, entered a pre-trial intervention program or have any criminal charges now pending?
Yes    No

Would you be willing to allow Goodwill of North Florida to perform a background check on you? 
Yes    No

Volunteer History: (List any Organizations, Agencies, Churches, Clubs, etc. you have volunteered with)

Volunteer Interest:

Merchandising Assistant (Store)    Employment Assistant (Job Junction)    Other:

Please indicate the days and times you wish to volunteer: (Weekends are store only)

Monday:     Tuesday:    Wednesday:

Thursday: Friday:        Saturday:    

Sunday:  

Please list 3 references below: (people not related to you who you have known at least one year)