Name
Address
City, State, Zip Code
Daytime Phone
Evening Phone
E-Mail
CA Drivers License #
Vehicle License #
Vehicle Type
Emergency Contact
Emergency Contact Phone
Emergency Contact E-Mail
* These are required fields.  Then Submit but we would like to know more about you so please fill out the fields below.    
Occupation, Computer Skills, Talents and Languages that would help assist our military clients
Certification or Licenses Held
How did you become interested in the volunteer program?
What assignments would you prefer?
What is your previous volunteer experience?
Sunday
Monday
Tuesday
Wednesday
What hours are avaliable to volunteer at the center?
Thursday
Friday
Saturday
Do you have any limitations related to health or physical ability?  If so, please explain:
Have you been convicted of a violation  of Section 243.4 of the Penal Code, a sex offense against a minor, 
or of any felony, which requires registration pursuant to Section 290 of the Penal Code?
AUTHORIZATION TO CONDUCT BACKGROUND CHECK (See Volunteer Letter)

I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application
or immediate discharge from the JFTB Volunteer Corps, whenever it is discovered.

I certify that the information contained in this application is true and correct to the best of my knowledge.  The JFTB personnel may verify any of the statements contained in the application. I authorize the JFTB personnel to conduct a background investigation that includes criminal history, driving record DOJ and FBI information and any information from previous employment.  I release the parties and persons from any and all liability of such information by the JFTB or any of its agents or representatives.

I authorize background check
(This section is optional)
Volunteers are recruited and selected on their interests, skills, knowledge and abilities.  A diverse corps of volunteers is both necessary and desirable.  The program office uses the following demographic information to meet diversity goals.
Please check one:
Please check one:
Print Applicant Signature
Date
Ready for your Volunteer Orientation Meeting?
Please call our help desk for an appointment @ 562.936.1796 You can also e-mail the Volunteer Coordinator. Click here
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YesNo
YesNo
Black (Not Hispanic)
White (Not Hispanic)
Hispanic
American Indian
Alaskan Native
Asian
Pacific Islander
21-25
26-35
36-45
46-55
56-65
Over 65