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2. SUMTER COUNTY BOARD OF COUNTY COMMISSIONERS
   EMPLOYEE SERVICES DIVISION
   7375 Powell Rd
   Wildwood, FL, 34785
   352-689-4400
4. VOLUNTEER APPLICATION

   ***YOU MUST BE AT LEAST 16 YEARS OLD TO APPLY***

8. PERSONAL INFORMATION
10. Name (Last, First)
11. Date of Application*
    Date of Application
13. Street Address, City, State, Zip
15. Mailing Address, City, State, Zip (If different from Street Address)
17. Email Address*
18. Telephone #
20. Have you previously volunteered here?*

    1. Yes
    2. No
21. Dates Volunteered?
23. How many hours can you volunteer?
25. Are those hours per:*

    1. Day

    1. Week

    1. Month
27. Days Available*

    1. Monday
    2. Tuesday
    3. Wednesday
    4. Thursday

    1. Friday
    2. Saturday
    3. Sunday
29. Time of Day Available*

    1. Morning

    1. Afternoon

    1. Late Afternoon
31. In which general volunteer area are you interested?

    1. Animal Services

    1. RACES Radio Operator
33. Please explain what interest or qualifications you have as a volunteer for this position. Include any relative skills.
37. References
39. Name
41. Address
43. City
44. State
45. Zip
47. Telephone #
48. Relationship
52. Name
54. Address
56. City
57. State
58. Zip
60. Telephone #
61. Relationship
65. Name
67. Address
69. City
70. State
71. Zip
73. Telephone #
74. Relationship
78. Agreement
80. Sumter County appreciates your willingness to volunteer your services to assist the County, its patrons, and the community. In signing this form as a Volunteer you are acknowledging that your services for the County are gratuitous and are intended as a contribution by you for public service for the County, its patrons, and the community and, as such, that you will be entitled to no compensation or any fringe benefits or other employment rights applicable to the employees of the County departments. It is expressly understood that you are not an employee or agent of the County and that we will provide you with necessary information and guidance to perform your volunteer services. You or the County may terminate this volunteer agreement anytime. While on the County premises you will agree to abide by all of the rules of conduct governing the staff and employees of the department in performing your services. Your signature below authorizes Sumter County to conduct background checks on the information provided. I certify that the information provided is true and accurate to the best of my knowledge.
82. Applicants are conditionally offered a volunteer position based on the successful completion of a post offer background investigation; and reference check. Offers may be withdrawn due to the applicant's failure to successfully complete any of the above post offer requirements.
84. By signing electronically, (Typing your name below) , I agree that this electronic signature is as binding as a written signature.
Leave This Blank:


88. 1. Receive an email copy of this form.
89. Email address

    This field is not part of the form submission.

90. Submit

* indicates a required field