V.I.P. Program Application

 

Date of Application: ___________________

 

___ New V.I.P. ___ Returning V.I.P.

 

Name: _______________________________ Home Phone Number: ________________

 

Address: ________________________________________________________________

City State Zip

Email Address: ______________________ Cell Phone Number: __________________

 

School: ____________________________ Age & Grade: ________________________

 

Name of Parent/Guardian: __________________________________________________

 

Home Number: ________________________ Work Number: _____________________

 

Emergency Contact (other than parent): _______________________________________

 

Relationship: ____________________________ Phone Number: __________________

 

Have you ever participated in volunteer work before? _____ Yes _____ No

 

If yes, please explain: ______________________________________________________

 

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Why do you want to participate in the V.I.P. Program? ___________________________

 

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How did you hear about the V.I. P. Program? ___________________________________

 

Please list any skills or special interests________________________________________

 

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In a short paragraph tell us something about yourself _____________________________

 

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