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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