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Town Volunteer Application
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First Name
*
Last Name
*
Address
*
Phone Number
*
Secondary Phone Number
Email Address
*
Employment Status
*
Full Time
Part Time
Retired
Other
Are you currently a student?
*
Yes, Full Time
Yes, Part Time
No
If yes, list current school and grade
If you require a specific number of volunteer hours, please specify hours and deadline below
Which Town of Los Gatos Volunteer position(s) are you interested in?
*
Current volunteer opportunities are listed on our Community Unity webpage at www.LosGatosCA.gov/CU,
or by following the link below:
COMMUNITY UNITY
Availability
*
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Preferred Times
*
Desired numbers of hours per week
*
List any previous volunteer experience
*
Please provide one reference (Non-relative)
Name
*
Relationship
*
Phone Number
*
Email Address
*
Emergency Contact Information
Name
Relationship
*
Phone Number:
*
Secondary Phone Number
Have you ever been convicted of a felony?
*
Yes
No
If yes, please specify:
I declare under penalty of perjury that the statements made in this application are true, and I acknowledge that any false statements or
misrepresentations on this application may be cause for refusal of placement or immediate dismissal from volunteer status. I further authorize the Town of Los Gatos to investigate the matters contained in this application, and I am aware that fingerprinting and background investigation are required for placement in any sensitive volunteer positions.
*
I agree
I do not agree
If under the age of 18, parent or guardian consent is required to participate in this volunteer program. Please check the box below if you are 18 or older.
I certify that I am 18 years of age or older
If applicant is under the age of 18, a parent or guardian must give consent by intialing below:
* indicates required fields.
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