Music National Service Volunteer Application
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Personal Information
Help us get to know you.
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| Name
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| Prefix
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| First
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| Last
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| Suffix
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| Email
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| Address
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| Street Address
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| Address Line 2
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| City
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| State / Province / Region
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| Postal / Zip Code
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| Country
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| Phone Number
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| Do you have a website?
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| In a few sentences, please explain why you are interested in serving as a Music National Service Volunteer.
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Availability
Please mark which hours and days you are available to volunteer. (check all that apply)
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| Morning (9am - 12pm)
| Monday Tuesday Wednesday Thursday Friday
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| Early Afternoon (12pm - 3pm)
| Monday Tuesday Wednesday Thursday Friday
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| Late Afternoon (3pm - 6pm)
| Monday Tuesday Wednesday Thursday Friday
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| Special Events
| Weekends Evenings
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| How many months are you interested in volunteering for?
| (minimum commitment of 4 months is required)
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| What type of setting are you most interested in volunteering in?
| Elementary School Middle School High School Hospital* Afterschool Program Community Center * Please note the following requirements of volunteering in a hospital setting:
-You are required to be at least 18 years of age
-You must complete a background check and health screening
-You must complete a hospital orientation, followed by a department orientation prior to providing direct service
-You are expected to serve 1 shift/week for at least six months.
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Language Ability
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| What is your primary language?
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| If other, please write in:
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| Secondary language?
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| If other, please write in:
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| Please share your skill-level in your Secondary language:
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| Do you speak any other languages?
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Experience
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| Please describe your musical background, including what instrument/(s) you play, how many years you have played, and any other relevant experience playing or performing music.
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| Summarize any special skills and qualifications you have acquired from employment, previous volunteer work, or through serving youth and/or other high-need populations.
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Reference #1
Please provide information for a reference from your previous work, volunteer, or educational experience.
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| Name
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| Title and Organization
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| Relationship to you
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| Email
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| Phone Number
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Reference #2
Please provide information for a reference from your previous work, volunteer, or educational experience.
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| Name
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| Title and Organization
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| Relationship to you
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| Email
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| Phone Number
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Reference #3 (Optional)
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| Name
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| Title and Organization
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| Relationship to you
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| Email
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| Phone Number
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How did you hear about volunteer opportunities with MusicianCorps?
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| Please check all that apply:
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| Music National Service website VolunteerMatch.org Idealist.org Another online source Friend/Colleague Other
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| If Other, please specify:
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Emergency Contact
Who should be notified in case of an emergency?
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| Name
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| Address
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| Street Address
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| Address Line 2
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| City
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| State / Province / Region
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| Postal / Zip Code
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| Country
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| Main Phone Number
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| Work Phone Number
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| Email
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Agreement
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.
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*
| Check here to affirm this statement.
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Our Policy
It is the policy of The Center for Music National Service to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.
Thank you for completing this application, and for your interest in volunteering with Music National Service.
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Image Verification
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