Volunteer Application

Starkey, Inc. accepts and encourages the involvement of volunteers within all approved programs and recognizes that volunteers are considered a valuable resource to the organization. All individuals will be screened based on their qualifications, education and skills without regard to age, sex, race, religion, national origin, disability, or marital status.

 

General Information

First Name (required)
Last Name (required)
Address (required)
City (required)
State (required)
Zip (required)
Home Phone
Work Phone
Cell Phone
Email (required)
Are you 18 years or older?

Volunteer Information

Are your volunteer activities part of a school requirement or other formal program?
If you answered yes to question #1 above, provide name of school or program:

Have you volunteered at Starkey before?
If yes, indicate dates of volunteer assignment and position held:
I prefer to volunteer  Summers only Year-round During school year

Volunteer Availability

Date Available
Please choose the day and time frame you would prefer to volunteer
 Monday Tuesday Wednesday Thursday Friday Saturday Sunday Morning Afternoon

Education

High School Diploma or GED?
Name of School
Major
Credit Hours
Degree
College
Name of School
Major
Credit Hours
Degree
Graduate School
Name of School
Major
Credit Hours
Degree

Business, Vocational or Other

Name of School
Major
Credit Hours
Degree
Please list volunteer interests, skills, and experience

References

List two individuals who have knowledge of your experience or education
Name
Telephone Number
Address
Name
Telephone Number
Address
Emergency Contact
Name
Relationship
Best daytime phone number
Best evening phone number

I certify that all statements contained in this application are complete and correct to the best of my knowledge. I also agree that if I am accepted as a volunteer,
I will abide by all policies and procedures of Starkey, Inc.'s volunteer program.

Additionally, I authorize Starkey, Inc. to conduct background checks if required for the volunteer assignment.

Please initial your acceptance of these terms. (required)
Opportunities for volunteers are provided without regard to race, color, sex, religion, national origin, ancestry, marital status, disability, veteran status, or age.