Volunteer Application
Name: __________________________________________________________ Male Female
Address: ________________________________________________________ Birthday ___________
City: _________________________ State: ________ Zip: ______________
Best Phone: ______________________________________________________
Emergency Contact _______________________________________________Phone:______________
Please check all that apply: Volunteer is a
q Current or Former Head Start parent
Volunteer Preferences
q Working with children in the classroom
q Assisting with clerical duties
q Assisting with kitchen
q Teaching arts and crafts
Other: _________________________________________________________________
Location Preferences
q East Dallas
q Oak Cliff
q Irving
q West Garland
Other: _________________________________________________________________
Head Start Volunteer Hours are Monday – Friday 7 a.m. – 5:30 p.m.
What days and times are best for you? ____________________________________________________
Do you have any physical limitations that might affect your ability to perform certain types of work?
Y N
Skills and Interest
Educational background: ______________________________________________________________
Hobbies, skills, interests: ______________________________________________________________
Previous volunteer experience: _________________________________________________________
All Head Start volunteers are subject to a criminal background check. The Texas Department of Family and Protective Services requires the following information in order to conduct the check.
Driver's License Number: ___________________________ State: ___________
Social Security Number: ____________________________ Race: ___________
Signature __________________________________________ Date ___________
FALSIFICATION OR MISREPRESENTATION OF ANY INFORMATION ON THIS FORM OR ON YOUR APPLICATION MAY CONSTITUTE GROUNDS FOR IMMEDIATE TERMINATION OF VOLUNTEER STATUS.