Thank you for your interest in volunteering with the City of Grand Island!  Please complete this application in order to be considered for a volunteer opportunity with the City of Grand Island.  Completion of the form placed you under no obligation and all information will be treated as personal and confidential.

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1

General Information:

 *

General Information:

Date:

Name (First and Last):

Address:

City, State, Zip:

Phone: ext.

E-Mail:

2

Department(s) Interested in Volunteering For:

 *

Department(s) Interested in Volunteering For:

Greenhouse

Heartland Public Shooting Park

Library

Park Cleanup/Adoption

Police Department

Youth Coach

3

Are you at least 16 years of age?

Are you at least 16 years of age?

Yes

No

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4

Personal Information:

Personal Information:

Experiences and Training and/or Special Skills and Abilities:

Restrictions or Limitations of Service:

Availability to Work (days & time):

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5

Personal References:

Personal References:

Name (First and Last):

Phone: ext.

Name (First and Last):

Phoneext.

Name (First and Last):

Phoneext.

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6

Employment Data:

Are you currently employed?

Employment Data: Are you currently employed?

Yes. If yes, please provide work phone number: If other, type text here.

No

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