Thank you for considering the Connecticut Asian Pacific American Commission as a place to donate your time and talents. Volunteers are vital to the APAAC. Without them, we wouldn’t be able to meet the needs of the APA community. We know that your time and talent are precious, and we want every minute you spend with us to be worthwhile. That’s why we’re asking you to take a few minutes to fill out this application. It will help us begin to make the right match between your skills and interests and the opportunities available. Thank you for your cooperation in this effort and your interest in the APAAC. If you have any questions about this or any part of our application process, please contact apaac@cga.ct.gov Volunteer Application Please print □Mr. □Mrs. □Miss □Ms. □Rev. □Dr. □Other First Name……………………………. Middle Name …………………………… Last Name Address City/State/Zip. Telephone Email………………………………………………… Are you 18 years of age or over? □ Yes □ No Education (highest level completed) Grades 1-5 6-9 11-12 College Graduate Former work/occupation Most recent employer (optional) List previous volunteer experience Skills (List your skills and indicate proficiency level) Skilled Can Teach Amateur 1. 2 3 Languages Fluent Read Write 1 2 Volunteer availability: (Circle all applicable) Number of Days per week: 1 2 3 4 5 Monday Tuesday Wednesday Thursday Friday No Preference Transportation: (How you will get to your assignment) Public Trans. Walk Self-Car Interests: □Fundraising □Tutor □ Interpreter □translator □ research □Membership □Outreach □Special Events □ Youth Sports How did you learn about volunteer opportunities at the APAAC? …………………………………………………………………………………………………………. Why would you like to volunteer? ………………………………………………………………………………………………………….. Do you need community service hours? □Yes □No Are the hours for: □School or □Court Appointed Emergency Contact: Name Relationship Address City/State/Zip Telephone VOLUNTEER ACKNOWLEDGEMENT PLEASE READ CAREFULLY BEFORE SIGNING IF VOLUNTEER IS AT LEAST 18 YEARS OLD, THEN VOLUNTEER MUST READ AND SIGN BELOW: I understand as a volunteer, that I am not an employee of the APAAC and understand and agree that I will not receive any compensation or benefit nor be eligible for any coverage under the Connecticut State Workers Compensation Laws. I HAVE CAREFULLY READ THE FOREGOING STATEMENT, UNDERSTAND ITS CONTENTS, AND ACKNOWLEDGE THAT I AM SOLELY RESPONSIBLE FOR ANY INJURIES INCURRED WHILE VOLUNTEERING WITH THE CONNECTICUT ASIAN PACIFIC AMERICAN AFFAIR COMMISSION. Printed name of Volunteer Signature of Volunteer Date