Sand Mountain Youth Center    Volunteer Youth Worker Application
Name____________________________________________________________Age_______

Address__________________________________________________________Sex________

Phone Number_____________________________________________________
Past Experience with youth:

Area of Most Interest (Chaperone, Arts and Crafts, Homework Helping, etc) :

List any Civic, Church, or Community Organizations you are a part of:
 References:
Name____________________________________________________________Phone________
Address__________________________________________________________City___________
Relationship_____________________________________________________________________

Name____________________________________________________________Phone_________
Address_____________________________________________ _____________City__________
Relationship_____________________________________________________________________

Youth Reference:
Name____________________________________________________________Phone__________
Address__________________________________________________________City____________
Relationship______________________________________________________________________

Most convenient time to volunteer: (please list days and times)

Monday-Fridays afternoons or nights?
Weekly_____________Monthly_____________Other_______________
Signed_____________________________________________________
Return to : Sand Mountain Youth Center PO Box 2497 Rainsville, AL 35986         
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