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Red Ribbon Trails

(A program of FCAN)

New Volunteer Application Form

Check one:

Personal Information (please fill out completely)


Address Apt. #
City State
 
Cell
Work phone

Occupation

Employer


Health

1) Will you be bringing medications to the retreat/camp?

2) If yes, do any of your medications require refrigeration?

Red Ribbon Trails recommends that all attendees have had a tetanus shot within the last 10 years or receive a booster before attending a Red Ribbon Trails event.

(TB Tests are recommend but not required.)

Red Ribbon Trails recommends all attendees to have been tested for TB within the last year.  Those who have tested positive for TB in the past must provide a letter, (dated within the last year), from their physician advising of their TB status and their ability to attend and/or work at a retreat/camp with immune comprised attendees, including HIV+ persons, to attend Red Ribbon Trails events.


Emergency contact information

Address Apt. #
City State
 
Evening phone

Volunteer experience
Organization #1 From
Supervised by Phone Extension
Roles, duties and responsibilities    

Organization #2 From
Supervised by Phone Extension
Roles, duties and responsibilities    

Organization #3 From
Supervised by Phone Extension
Roles, duties and responsibilities    

Experience and/or training for working with youth
Organization #1 From
Supervised by Phone Extension
Roles, duties and responsibilities    

Organization #2 From
Supervised by Phone Extension
Roles, duties and responsibilities    

Organization #3 From
Supervised by Phone Extension
Roles, duties and responsibilities    

Experience and/or training for working with persons with HIV/AIDS
Organization #1 From
Supervised by Phone Extension
Roles, duties and responsibilities    

Organization #2 From
Supervised by Phone Extension
Roles, duties and responsibilities    

Organization #3 From
Supervised by Phone Extension
Roles, duties and responsibilities    


References: Persons not related to you who have knowledge of your qualifications

Address Apt. #
City State
 
Evening phone

Address Apt. #
City State
 
Evening phone

Address Apt. #
City State
 
Evening phone

Interests and experience

Please list any specific interests/talents you would like to share with campers.

Would you be willing to lead an activity?
If YES, what activity?


Check all areas of interest below

Physical activities


Do you have experience in any of these sports? If so, which?

Are you currently a certified lifeguard?

Musical activities


Do you play any musical instruments? If so, which?

Photography


Are you familiar with printing digital photos?

If yes, are you Macintosh proficient?

Creative activities

Do you have any specialties?

Therapeutic activities

Please list specific training and certifiation


Age groups: Indicate age group(s) with which you have most experience or prefer to work.