VIMS Volunteer Application

Home Phone:

Mobile Phone:

Email Address:

Best Time to Reach You:

Current Occupation/Title/Grade in School (if applicable):

Employer:

Supervisor:

Duties

Highest Academic Certificate/Degree Earned:

Date:

Major:

High School / College:

Other degrees/certifications:

Do you speak a foreign language, or know sign language?

How did you learn about our volunteer program?

Previous volunteer experience:

If yes, please explain:

Reference 1 Name:

Telephone Number

Reference 2 Name:

Telephone Number