Application

  Please complete the following application if you would like to be an ACTS volunteer. You may submit the application via email with this form or fill out the print version and mail to :
   
  ACTS Volunteer Coordinator
P.O. Box 74
Dumfries VA 22026
 
 
*Required Fields
* First Name * Last Name
* Address * City
* State * Zip
* Date of Birth * Email Address
Home Phone
(012-345-6789)
* Work/Cell Phone

(012-345-6789)
 
How did you hear about the ACTS Volunteer Program?
 
 
* If you are Volunteering to fulfill a Community Service Requirement, please provide the following information:
 
Yes No
 
Reason for Community Service?  

Number of Hours Required

  
Required Completion Date   (mm/dd/yy)
 
* Emergency Contact Information:
 
Name Relation
Phone #1 Phone #2
 
Educational Background:
 
Highest Level Attained
Field of Study
Current Occupation or
Volunteer Position
 
Skills & Interests: (check all that apply)
 
Computers Typing Telephone Skills Fundraising
Languages Teaching Public Speaking Photography
Calligraphy Writing Home Repair Landscaping
Babysitting Painting Auto Repair Lawn Maintenance
  Languages & Special Skills not listed above:
 
 
For which ACTS Program would you like to Volunteer?
 
Turning Points Help Line Helpline TEEN Food Pantry
Emergency Assistance Day Care 1 Day Care 2    
Transitional Living Shelter Thrift Store    
 
Which Volunteer opportunities interest you?
  INDOOR ACTIVITIES
 
  Work in our office performing general administrative duties
  Serve on a Committee to organize Fundraising special events
  Enroll in training to provide assistance directly to clients:
    (Requires a follow-on time commitment of at least 6 months)
  Emergency Assistance Caseworker
  Turing Points Advocate/Group Leader
  HelpLine Phone Listener
  Teach a life skills class
  Babysit for a client attending life skills classes
  Receive & Stock Merchandise in the ACTS Thrift Store
  Dumfries Location
  Woodbridge Location
  Work in the Emergency Food Pantry
  Help organize food drives
  "Adopt" a room in one of the shelters
  Translate for a non-English speaking clients
 
What language?
  Assist with Grant writing & research
  OUTDOOR AVTIVITIES
 
  Pick up donated food and other items from local businesses
    (Requires a car)
  Assist with Thrift Store pick-ups
  Maintain play areas and shelter grounds
  Plant flowers and shrubs in shelter yards
  Assist with outdoor special events and fundraisers
 
* Availability (please list the days and hours you would like to work)
 
  Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Morning
Afternoon
Evening
 
 
I would Prefer Regular Schedule
  Flexible Schedule
  On Call as Needed
 
Optional:
  Do you or a family member have contact with a private foundation that might be helpful to ACTS? And would you be willing to share this information with a staffer at ACTS?
 
Yes No
 
Is there anything else that you would like us to know about you?
 
 
I agree to treat all information revealed to me as confidential. I will do my best to live up to my volunteer commitment and I will notify my supervisor in advance if I must miss my assignment for any reason. You will be required to sign a copy of this application once you come into to Volunteer.
 
* Full Name:
 
Thank you for your time. Once you have filled out the application please call 703-441-8606, ex. 213
M-F 8:30 - 4:30
 
 
 
 
 
 
 

 

 

 

 

 

 
P.O.Box 74 Dumfries VA 22026 Phone 703-441-8606 FAX 703-221-3585