Volunteer Application: LARGE
Maryland State Department of Education
Division of Rehabilitation Services
Application for Volunteer Services
Volunteer Services 410-554-9459 ● TTY 410-554-9411 ● Fax 410-554-9112 ● volunteer@dors.state.md.us
Name of Volunteer:
Address:
City: Baltimore State: MD Zip Code: 21234
Home Phone: Business Phone:
Cell Phone: Email:
Business Name & Address:
City: State: Zip Code:
Occupation:
Birth Month: Birth Day:
Are you 16 years old or over? Yes No
Tell us why you decided to volunteer with DORS?
Where did you hear about DORS need for volunteers?
Tell us about work experience, hobbies, special interests or talents you have to share:
The following volunteer activities are available at all locations. Check the ones that interest you.
Telephone/Reception
Office Support (filing, general clerical)
Reading for Others
The following volunteer activities are only available at the Workforce & Technology Center in Baltimore. Check the ones that interest you.
Clerical Assistant
Library Assistant
Gift Shop
Evaluation Assistant
Teacher's Aide
Other:
When would you like to volunteer? Indicate the times you would be available each day:
Monday Tuesday Wednesday Thursday Friday
Where would you like to volunteer? Check all that apply.
Western Maryland:
Cumberland Frederick Garrett County
Hagerstown Westminster
Southern Maryland:
Annapolis Glen Burnie Leonardtown
Prince Frederick Waldorf
Baltimore City:
1010 Park Avenue
Workforce & Technology Center/2301 Argonne Dr.
Gaslight Square (1401 Severn Street 21230)
Eastern Shore:
Easton Salisbury
Central Maryland:
Bel Air Columbia Elkton Owings Mills Towson
DC Suburbs:
Germantown Lanham Oxon Hill Wheaton
Please give us the names of two people we can contact as references (non-relatives):
Name of First Reference:
Address:
Phone: Email Address:
Name of Second Reference:
Address:
Phone: Email Address:
Please tell us who should be contacted in case of emergency
Name: Relationship:
Address:
Phone: Email Address:
Signature of Applicant: Date:
The Maryland State Department of Education does not discriminate on the basis of race, color, sex, age, national origin, religion or disability in matters affecting employment or in providing access to programs.
Office Use Only – Do Not Write In This Space
Assignment Orientation
Volunteer Handbook Training
Job Description ID
Mailing List
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