Anointed Community Services International, Inc.
Volunteer Application

Information on this form will be used for recordkeeping and statistical purposes. Please print clearly. Completed application should be sent by email to : info@anointedcs.org.

For questions call : 352-404-7898

First Name

Middle Name

Last Name

Address

City

State

Zip

Cell Phone

Home phone

Email

Date Of Birth

Gender (M / F)

Ethnicity

Current of former occupation

Are you a member of any community groups or civic clubs?

If yes, please list

Please note the times you are available by the day(s) you can volunteer:

Do you wish to be a Volunteer Trainer?

Are you interested in teaching Computers or Life Skills?

Is there anything else you might be willing to teach? If yes, please specify

SIGNATURE AND ACKNOWLEDGEMENTS

I understand that Anointed Community Services International will screen volunteers and may or may not accept a volunteer. I understand that I have an obligation to maintain confidentiality as it pertains to ACS information, all observations, all conversations, programs and ideas. I agree to remain confidential regarding ACS computer service, and/or the clients and their personal information. A breach of confidentiality will be a cause for termination as a volunteer and possibly criminal charges if I tamper with ACS's computer security at any time. I understand that Anointed Community Services will perform a nationwide background check on me. I also understand that my volunteer work is a commitment. When I cannot work at the assigned date and time, I will notify Anointed Community Services and the and/or the student learner at least 48 hours in advance or as soon as possible. I understand that this is a volunteer position with no benefits, and I understand that I will not be paid for my services as a volunteer and that I am giving my time freely to Anointed Community Services.

Applicant Signature :

Date :