CCJ Application


Application Type	Volunteer
	Student Intern
Program of Interest
Date
First Name
Last Name
Home Street Address
City
State
Zip Code
Home Phone
Cell Phone
Email Address

Occupation
Current Employer
Employer Address
City
State
Zip Code
May we contact your employer?	Yes
	No

Please list the specific skills and talents you possess that might be utilized in a position here at CCJ:

Do you speak any languages in addition to English?
	Yes
	No
Which language(s)
Please list any prior relevant volunteer and/or work experience(s): Be sure to list the Agency Name, Responsibilities, and Date of Service.


Please list each day of the week, and specific times, you are available:

Please indicate your educational background; please include school(s) attended and graduation date(s):


Please list three references: (do not list spouse or relatives)
1) Personal Reference
Name
Phone
Relationship
Years Known
e-mail

2) Employment Reference
Name
Phone
Relationship
Years Known
e-mail

3) Volunteer Reference
Name
Phone
Relationship
Years Known
e-mail

Please note: The above information will be kept confidential and will only be shared with personnel involved in the decision to accept volunteers and/or student interns at the Center for Community Justice.