Volunteer Application

Name *

First

Middle

Last *

Last

Home Phone

Mobile Phone

Address *

Address Line 2

City *

State *

Postal Code *

Email

Education Level *

Grammer school

High school graduate

College student

College graduate

College you are attending *

Degree being sought *

Expected Graduation Date *

Highest Degree Attained *

College where degree was attained *

Employment Status *

Student

Employed

Retired

Other

Current Employer *

Position/Title *

Employer's Phone Number *

Length of Employment *

Previous Volunteer Experience

Have you ever been convicted of a felony? *

No

Yes

Please describe your felony offense

Which program or group would you like to volunteer to work with?

Please describe any special skills or abilities that might contribute to your volunteer work

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Southwinds, Inc

Located in Pittsburgh, PA, we are a non-profit agency providing quality residential care and life skills training for adults with developmental challenges

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