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* required information |
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| * Name: |
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* Street Address: |
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| * City: |
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| * State: |
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| * Zip Code: |
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Business Phone: |
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* Home Phone: |
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| * E-mail: |
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Referred by: |
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Do you currently work? |
Full-time Part-time No |
* Available days and hours to volunteer: |
PLEASE NOTE: most volunteer positions take place between 9 a.m. and 5 p.m. Monday - Friday
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* Tasks of interest as a volunteer: |
Obtaining air dates for PBS programs
Educational Materials (editing, proofreading, filing)
Newsletter (writing, development, etc.)
Foundation Research
Programs
Special Events
Office Tasks (filing, phones, etc.)
Young Professionals
Other (if checked, please fill in the box below)
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| Other interests are: |
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* Would your volunteer experience at SCIS fulfill an academic or community service requirement? |
No Yes (If yes, please explain below:)
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Please list your previous work/volunteer experiences, beginning with the most recent: |
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* Please list skills you have, or would like to develop that would most benefit you while volunteering with SCIS: |
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* List three people (one per field) you have known at least one year. Please provide an address and phone number for
each and their relationship to you (i.e. teacher, family friend, etc.). Please do not list former employers or relatives: |
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* Please list the name(s) of school(s) attended (along with city and state): |
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* Please list your previous supervisors where you have worked or volunteered. If possible, please provide phone number: |
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Have you ever worked or been educated in a different name? If yes, please list all other names: |
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 I hereby authorize the Southern Center for International Studies to utilize the information above to verify my education and employment histories. If the job requires it, I also authorize a credit history to be conducted. I understand that any misleading information that I have given during this application procedure is false, and may be grounds for lack of consideration. Therefore, this information is true to the best of my knowledge.
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