Dear Applicant,

Thank you for your interest in helping the Alliance for African Assistance in its mission to assist

all refugees in the resettlement process through social, educational, and cultural support, guiding

them towards self reliance and full integration within the San Diego Community.

(SUPERVISOR   STARTING DATE

FOR OFFICIAL USE ONLY.

SECTION  A – PERSONAL DATA  (Please Print):

Mr. Mrs. Ms. Dr.                              First Name                           MI                        Last Name

Street Address                                                                          City                    State                      Zip 

Day Phone                             Evening Phone                     E-Mail                                       Date of Birth

       
Social Security   #                        Employer                                                                 Department

   Driver’s License

Education                                                                                                       State, Class, Number

Emergency Contacts: (Please list 2 people to contact in case of emergency.)

         
Name                                                                 Day Phone                                 Evening Phone

         

Name                                                                   Day Phone                              Evening Phone

SECTION B VOLUNTEER INFORMATION:

How did you become interested in volunteering here?

Briefly describe other volunteer’s work, or life experiences, training skills hobbies and special

interest you would like to share with us:

Do you speak any foreign languages?     

        Fluent        good         fair 

        Fluent        good         fair 

         Fluent        good         fair 

Do you belong to or volunteer for any other social service organization?

Which   

Do you have any physical limitations?          If yes, please describe:

Have you ever volunteered for AAA before? In what capacity?

When?

Have you ever been convicted of a felony?        If so explain

TIME COMMITMENT:  Please indicate your availability:

DAY       MON TUES       WED     THURS     FRI         SAT

TIMES                                           

VOLUNTEER AREAS: Please review the volunteer opportunities listed below and indicate the

Positions you are interested in.    If you have a skill or program ideas that is not listed, please write

 it in the space provided below:

REFERENCES:  Please give two references we may contact.  (Do not list relatives)

Please list name, address and phone numbers of reference.

I understand that the information given is true and will be held confidential.

Signature    date