Volunteer Application Form Apply to be a Volunteer Most opportunities are outdoor (e.g., Recreation and Parks, Community Revitalization).Name(Required) First Last Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP PhoneWhat is your Date of Birth(Required)MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Email(Required) Are you volunteering with a group (Note: Application must be completed by group leader)?(Required) Yes (If yes, please list group name and number of group participants in the box below.) No Have you ever been convicted of a felony?(Required) Yes No If so, please explain. And, how long ago was the conviction?Have you ever been convicted of a misdemeanor (does not include traffic violations)?(Required) Yes No If so, please explain. And, how long ago was the conviction?Have you ever been convicted of a traffic infraction?(Required) Yes No If so, please explain.Work/Volunteer historyAre you a current Henrico County Employee?(Required) Yes No Current and/or previous work history(Required)Hours of AvailabilityMonday – SundayGeneralWhat is your reason for volunteering?(Required) School Court Personal Other If "Other" please describePlease indicate your ideal volunteer environment by selecting one (or more) of the checkboxes below: Office setting (e.g., clerical work, administrative) Outdoor activities (e.g., paintbrush projects, park and school cleanups) Program and Events (e.g., volunteering for recreational programs and events) Other (please describe)Do you have a specific agency where you would like to serve (i.e., Libraries)?CAPTCHA
