The Town of Washington, LA.: Volunteer

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Volunteer

If you are interested in exploring volunteer opportunities, please fill out the application below.

Town of Washington Volunteer Application

Personal Information

Last Name First Name Middle Initial

Address

City State Zip Code

Home Phone Business Phone

Birthday Email Address

Employment History

Employed, please name Employer

Retired

Volunteer Experience:

Special Skills:

Carpentry Sewing Painting Photography
Electrical Art Framing Computer Graphics

How did you hear about volunteer opportunities at the Washington Historical Society and Museum?

Have you ever been convicted of any offense in violation of the law?	Yes No
If you answered yes, please explain:
Have you ever been accused, charged or convicted of any act of neglect, abuse or molestation involving a child?	Yes No
If you answered yes, please explain:

References:

(Please list two individuals who are not family members we may contact as references.)

1. Name

Address City Zip

Home Phone Business Phone

2. Name

Address City Zip

Home Phone Business Phone

Emergency Information:

Name Relationship

Address City Zip

Home Phone Business Phone

Cultural Diversity Information:

(The following information is requested for funding purposes only and is optional.)

Sex:

Ethnicity:

Please add me to the Town of Washington Historical Museum and Society email list.

Submit Application:

The submission of this application is an indication of interest in being a volunteer for the Town of Washington Volunteer Service program.

I give permission for the Volunteer Services of the Town of Washington to contact the persons listed as references and to complete a background check with this and other information provided.