2. Name*
4. Address:*
5. Telephone number:*
7. City, State Zip Code:*
9. Date of birth (if under age 21):
11. Email address:*
13. ****************************************
15. Are you applying to volunteer in order to fulfill a service requirement?*

    1. Yes
    2. No
17. If yes, please list the school or organization:
19. If you are a college student or graduate, please list your major:
21. Skills, interests or hobbies:
23. Please provide your T-shirt size.*
25. Please indicate your availability (days, seasons, hours, etc.) *
27. Have you ever been convicted of a felony or class A misdemeanor?*

    1. Yes
    2. No
28. If yes, please explain:
30. Do you have any physical or medical limitations, which may interfere with your ability to carry out certain assignments?*

    1. Yes
    2. No
31. If yes, please explain:
33. Provide the names and contact information of people we may contact in an emergency:
35. Name:*
37. Relationship:*
39. Phone number:*
41. Alternative phone number:
43. Name:
45. Relationship:
47. Phone number:
49. Alternative phone number:
51. Mark any program(s) for which you would like to volunteer.
53. SPRING

    1. Egg Hunt
    2. Spring Community Cleanup
    3. Memorial Day Parade
    4. NewBark PawLooza
54. SUMMER

    1. Camp GWC
    2. Safe Kids Camp
    3. Rittenhouse Camp
    4. Specialty Camps
    5. Camp REAL
    6. Liberty Day
56. ****************************************
58. FALL

    1. Newark Community Day
    2. Fall Community Clean Up
    3. Halloween Parade
    4. Halloween Party at the George Wilson Center
    5. Turkey Trot 5k/10k Race
    6. Thanksgiving Day Breakfast
    7. Mayor’s Fall Harvest Festival
59. WINTER

    1. Winterfest
    2. Santa’s Secret Shoppe
    3. Snack With Santa
61. ****************************************
63. YEAR ROUND

    1. Adopt-a-Park
    2. Eagle Scout Project
    3. Park Litter Pick Up
    4. Park & Trail Maintenance
    5. Community Gardens
    6. Sports Coaching
    7. Mayor’s Special Events
64. OTHER
66. ****************************************
68. After receiving your application, the program coordinator(s) for each program will contact you with additional information regarding your volunteerism. Some programs may require background checks and/or additional information.
70. ****************************************
72. Required If Under 18 Years of Age: I certify that my son/daughter is fully capable of participating as a volunteer and has my permission to be assigned.
74. Parent or Guardian Name:
76. Date:
78. I agree to the terms of the volunteer application.

    1. Yes
    2. No
80. ****************************************
82. Volunteer Policy (read and understand the following)
84. The City of Newark Parks and Recreation Department, hence forth referred to as the City, cannot guarantee placement. The City will, however, make every effort to match volunteer applicants to volunteer opportunities. The City reserves the right to reject a candidate for any reason which the City, in its sole judgment, determines will or may affect the best interests of the City. Furthermore, the City reserves the right to withhold the reason(s) for such refusal.

    The City accepts the service of all volunteers with the understanding that such service is at the discretion of the City. Volunteers agree that the City may at any time, for whatever reason, decided to terminate the volunteers relationship with the City.

    Volunteers may at any time, for whatever reason, decide to sever the volunteer’s relationship with the City. Notice of such a decision should be communicated as soon as possible to the volunteer’s supervisor. The City of Newark does not provide Worker’s Compensation or any other insurance coverage for volunteers.*

    1. I have read and understand the above information.
    2. I do not understand the above policy
86. The City if Newark is an equal opportunity employer. No person or group shall be excluded from participation, denied any benefits, or subjected to discrimination on the basis of race, national origin, or handicap.
Leave This Blank:


88. 1. Receive an email copy of this form.
89. Email address

    This field is not part of the form submission.

90. Submit

* indicates a required field