GENERAL INFORMATION
Last Name:
First Name:
MI:
Street Address:
City:
State:
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Washington
West Virginia
Wisconsin
Wyoming
Zip Code:
Daytime Phone:
Evening Phone:
E-Mail:
Fax Number:
Age:
What group are you representing?
VOLUNTEER TIME INTEREST
How much time do you have to volunteer for Special Olympics Virginia (SOVA)? (Check One)
One Day Event
Seasonal Involvement
Year-Round
SPECIFIC VOLUNTEER JOB INTERESTCheck your interest(s).
Category
Local Program
Administrative/Office Support
Event Management Team
Medical Services
Fund Raising/Development
Student Intern
Please mark sport interest in the right hand table for the following categories.
Coach/Assistant Coach
Official
Sports Clinician
Unified Partner (Playing on Teams with Special Olympics Athletes)
SPECIAL SKILLS(Please check any special skills or interests you have that you would be willing to share with a Special Olympics program or event)
Accounting
Computer Skills
Entertainment
Graphic Design
Photography
Proposal/Grant Writing
Public Speaking
Sign Language/Interpreting
Videography
Writing
Other: (Specify)
PREVIOUS SPECIAL OLYMPICS EXPERIENCEDo you have any prior Special Olympics experience? (Describe)
VOLUNTEER BACKGROUND INFORMATION (QUESTIONS MUST BE ANSWERED)
The information that I have provided may be verified and I give my permission to Special Olympics Virginia (SOVA) to make inquiry of others concerning my suitability to act as a SOVA Volunteer. This inquiry, when deemed necessary, may include a Criminal History Record and/or Sex Offender and Crimes Against Minors Registry Search carried out through the Virginia State Police, or another state or national agency of SOVA’s choice. In the course of volunteering for SOVA, I may be dealing with confidential information and I agree to keep it in the strictest confidence. I grant SOVA permission to use my likeness, voice, and words in television, radio, film, or any form to promote the activities of Special Olympics.
BY CLICKING ON THE SUBMIT BUTTON BELOW, I ATTEST THAT I HAVE READ THE ABOVE AND THAT THE INFORMATION I HAVE GIVEN IS TRUE AND COMPLETE. I UNDERSTAND THAT IF ANY INFORMATION CHANGES DURING MY TENURE AS A VOLUNTEER, I WILL NOTIFY SOVA OF THE CHANGES.
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