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Application for Volunteers
Sign in to Save Progress
This form has been modified since it was saved. Please review all fields before submitting.
Name
Address
City
State
Zip
Email Address
Phone
Days/Times You Would Be Available
Sunday through Saturday; a.m. vs. p.m.
Please explain why you are interested in volunteering and if you have any special qualifications.
References
Please list three references that we may contact regarding your work experience.
Reference 1
Name
Phone
Years Acquainted
Reference 2
Name
Phone
Years Acquainted
Reference 3
Name
Phone
Years Acquainted
Acknowledgment
As a volunteer for the City of Westbrook I understand that I will not receive compensation for my services and that I am ineligible for benefits provided to city employees.
I acknowledge
Contact Information
For more information, please contact Human Resources at 207-854-9105.
Authorization of Background Investigation
I hereby authorize the City of Westbrook to conduct an Investigation through the Motor Vehicle Division of the Maine Secretary of State for vehicle related record checks and through the Maine State Bureau of Identification or other source for criminal record checks. I hereby release the City of Westbrook from any and all liability for any claims or damages arising out of its investigation as outlined above or from the City's use of the information provided.
I understand that if l do not agree to execute this, I will not be considered a volunteer for the City of Westbrook, and that any misrepresentation of information contained herein will preclude me from consideration as a volunteer with the City of Westbrook.
I authorize a background investigation.
Other Names Used, if any
Date of Birth
Phone
Residential Addresses for the Past 7 Years
Residential Address 1
Street Address
City
State
Zip
Residential Address 2
Street Address
City
State
Zip
Authorization of Background Investigation
Applicants under 18 years of age must have a parent or court appointed guardian sign this authorization of background investigation.
Parental Consent
I hereby give my consent for the above-mentioned applicant to have a background check performed on him/her. Furthermore, I hereby understand and agree to the conditions of this release as described above.
Parent/Guardian Signature
Parent/Guardian Name
Date
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Email address
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