2. Volunteer Application
3. Date*
   Date
5. Name*
7. Address*
8. P.O. Box / Apt. Number
10. City*
11. State*
12. Zip*
14. Email Address*
15. Primary Phone Number*
17. Alternate Phone Number
19. Date of Birth*
    Date of Birth
    *For placement / purposes only
20. Languages You are Fluent In
    *Other than English
22. Physical Limitations*
24. Emergency Contact Name*
25. Emergency Contact Phone Number*
27. Have You Ever Been Convicted of a Felony Charge?*

    1. Yes

    1. No
29. Check All of the City Departments You Are Interested in Volunteering With*

    1. Animal Services
    2. Irving Arts Center
    3. Keep Irving Beautiful

    1. Library
    2. Municipal Court

    1. Parks and Recreation
    2. Police
31. Days Available to Volunteer*

    1. Sunday
    2. Monday

    1. Tuesday
    2. Wednesday

    1. Thursday
    2. Friday

    1. Saturday
33. Preferred Hours
    Preferred Hours Start Time

    —

    Preferred Hours End Time
35. Race / Ethnicity

    If accepted as a volunteer, the following demographic question is optional

    1. Asian
    2. Black

    1. Hispanic / Latino

    1. Native American

    1. White
37. Note: Additional department specific information may be required.
41. For Office Use Only
Leave This Blank:


49. 1. Receive an email copy of this form.
50. Email address

    This field is not part of the form submission.

51. Submit

* indicates a required field