OMNI Youth Services | Youth Volunteer Application (for volunteers age 14 to 18)

Contact Information

Name*

FirstLast

Address*

Street AddressAddress Line 2CityStateZip Code

Home Phone*

Email*

Date of Birth*

MM

DD

YYYY

Name of School*

School Address*

Street AddressAddress Line 2CityStateZip Code

Grade*

How did you hear about OMNI (i.e. newspaper; please be specific)?*

Are you committed to other volunteer service organizations (clubs, church, community, school)?*

1.*

2.*

3.*

4.*

When can you begin participating? *

Can you meet two to three times a month?*

If no, when are you available?

What foreign language (s) do you speak, read or write?

Have you ever been convicted of a crime? *

If yes, please explain*

Signature*

Phone

This field is for validation purposes and should be left unchanged.