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Volunteer Services
614 Division Street MS-7  Port Orchard, WA
Phone:(360)337-4650 * Fax:(360)337-7052
 
The following information will assist us in selecting and assigning volunteer roles, planning, training and collecting data. Please help us to get to know you.

Volunteer Application

PERSONAL INFORMATION

Name: 

Address: 

City: 

State: 

Zip: 

Home Phone: 

Work Phone: 

E-mail: 

EMERGENCY CONTACT INFORMATION

Name: 

Phone: 

Relationship: 

How did you hear about the Kitsap County Volunteer Program?

Please list your Employment or Volunteer History for the last five years:   
(List dates & supervisor)

Tell us about your Education: (Check the highest grade completed)
8 9 1011 12 13 14 15 16 17 18

Degree/s: 

Area of Study: 

Will you be receiving academic credit for your volunteer work?
    Yes No
PERSONAL REFERENCES
Please list the Names of two non-related references:

Name: 

Phone: 

Address: 

City: 

State: 

Zip: 

Relationship: 

Name: 

Phone: 

Address: 

City: 

State: 

Zip: 

Relationship: 

Do you have a vehicle or access to transportation?
Yes No

Are you age 18 or older? Yes No

When are you interested in volunteering? 
Days  Evenings  Weekends

What skills/experience would you like to share as a volunteer?

What volunteer positions interest you?

Do you have any experience working with seniors, youth, disabled or diverse populations or financially disadvantaged people?  If yes, please share your experiences.

Do you have any special requirements or medical conditions that we should be aware of as you volunteer?
Yes  No   If yes, please describe: 

CRIMINAL HISTORY BACKGROUND
Within the last seven years, have you been convicted of a violation other than a minor traffic offense?  Yes  No   If convicted, please explain the date and nature of the offense:

(You must report all convictions. If it is determined that they are not related to a volunteer position, you will not be disqualified.)

I hereby certify that the information on this application is true and complete. My typed/scanned signature authorizes Kitsap County Volunteer Services to verify any of the information on this application and to secure information deemed necessary from employers and personal references in order to determine my suitability for the volunteer position I am seeking with Kitsap County.

Signature:  Date: 

After pressing submit, you should see a confirmation page listing your responses.  If this page does not appear or if you have any other difficulty with this form, please contact Jan Koske (360) 337-4650 or jkoske@co.kitsap.wa.us.

 Last Updated:  November 26, 2008
Contact Jan Koske, Coordinator at (360) 337-4650 or email for more information.

Volunteer

Current Opportunities Updated 

Ongoing Opportunities

Online Volunteer Application

Application for Appointment to a Board

Volunteer Recognition

CASA 

Hours: 8:00 - 5:00
Monday - Thursday
 
Shawn Gabriel, Director
Administrative Services Department
 
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