Campbell: City of Campbell Volunteer Program (20376150) 1. Why do you want to volunteer? 2. Please describe your present or previous volunteer experience. 3. If you have interest or expertise in a subject matter, please describe: 4. Describe any limitations on volunteer work that you can perform at this time. 5. Availability - Please select the your preferred days of the week could you work. Monday Tuesday Wednesday Thursday Friday Saturday Sunday 6. Availability - Please select your preferred shifts. Mornings Afternoons Evenings 7. Availability - How many hours during your selected shifts would you be able to work? 8. Length of Commitment - Please select your length of commitment. One project only Up to 3 months 3 months or more Indefinite at this time 9. Which of the following general areas would you prefer to spend your time? (Select any that apply) Computer Technology Disaster Preparedness/Relief Downtown Redevelopment Office work Maintenance/Painting and Carpentry Museum/Theater Park projects/Gardening Public Safety Programs/Police Dept. Recreation/Sports Seasonal special events Working with Children Working with Adults Other 10. If other, please specify (If you did not select other, please indicate "N/A"): 11. Bilingual Skills - Do you have bilingual language skills? Yes No 12. Bilingual Skills - If your answer to the question above is "Yes": (1) Please list any languages, other than English, in which you are fluent. (If you are not bilingual please answer "n/a" to this question.) 13. How did you learn about the Campbell Volunteer Services Program? (Check all that apply) City Website Recreation Activities Guide Public Library Volunteer Exchange Another Volunteer Newspaper Other 14. If other, please explain. (If you did not select other, please indicate "N/A") 15. References - Please list three people who know you well and can attest to your character, skills and dependability. In your response, please include (1) Name; (2) Phone Number or Email Address; and (3) Length of relationship. 16. Acknowledgement - I choose to participate as a Volunteer for the City of Campbell and understand that my services are donated to the City of Campbell without contemplation of compensation or future employment, and given for humanitarian, religious or charitable reasons. I understand that I am covered under the City’s workers’ compensation insurance in the event of an injury from rendering a volunteer service. I will report any injury or incident to my supervisor immediately. I agree to abide by any rules and directions provided by those helping to administer the Volunteer program. I understand and agree to this important information