1.864.260.4515
info@acdsnb.org
212 McGee Road Anderson, SC 29625
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Volunteer Application
Name
*
First
Last
Phone Number
*
Email
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Are you 18 years of age or older? If "NO" a permission form needs to be filled out by parent or legal guardian.
*
Yes
No
Is there a particular time you prefer to volunteer?
*
Morning
Afternoon
Both
How would you most like to partner with ACDSNB?
Work with Individuals
Administrative/Office Task
Special Events
Maintenance/Technical Skills
Other
Do you have any experience with with individuals with disabilities?
Yes
No
Have you ever been employed with ACDSNB?
*
Yes
No
If "yes" please list the last position held at ACDSNB and the dates you were employed.
*
Have you ever been convicted of any violation of law (not including traffic tickets)?
*
Yes
No
If "yes" please provide conviction dates, type of crime and disposition. (Note: a conviction or "yes" response may not necessarily disqualify you)
*
Consent
*
I will abide by the mission, rules and regulations of Anderson County DSN Board, including health and safety procedures in relation to staff, individuals, and other volunteers.
Signature (please type full name)
*
Date
*
MM slash DD slash YYYY
