LLC XXI Atlanta 2017 Volunteer Application

Don’t miss out on being an LLC volunteer – Volunteer applications accepted until 2017 slate of volunteers are filled! Please fill out & submit to: by November 1, 2016.

Contact Information

o Real Name (check preferred name for Conference)
o Scene Name (badge preference)
Street Address
City ST ZIP Code
Home Phone
Work Phone
E-Mail Address

Availability

During which hours are you available for volunteer assignments? (minimum 4 hr scheduling)
__ Weekday mornings / __ Weekend mornings Additional information: ______
__ Weekday afternoons / __ Weekend afternoons ______
__ Weekday evenings / __ Weekend evenings ______

I would like to volunteer for ¨ 4 1 6 1 8 hours or 1 “as needed”. (may be spread out over the conference)

Interests

Tell us in which areas you are interested in volunteering

Special Skills or Qualifications

Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.

Previous Volunteer Experience

Summarize your previous volunteer experience.
______

Person to Notify in Case of Emergency

Name
Street Address
City ST ZIP Code
Home Phone
Work Phone
E-Mail Address

Agreement and Signature

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, discretion, confidentiality and professional deportment is a requirement of this position, failure to comply or misrepresentations made by me on this application may result in my immediate dismissal. Additionally if accepted I understand that as a volunteer I will receive a registration code that will vary based on previous LLC volunteerism. Depending on need and availability each volunteer will be expected to work a minimum of 4 to 6 hours.
Registration: Upon notification of acceptance you will receive a code
Name (printed)
Signature (electronic signature accepted)
Date

LLC Policy

It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.

Submit completed form to:

Subject line: VOLUNTEER

Thank you for completing this application form and for your interest in volunteering!

CC

Chair, LLC

www.leatherleadership.org

* Discounts do not apply if previously registered