Junior Volunteer Application

Click here for the pdf version of the Junior Volunteer Application or fill out online form below.

Fields marked with an "*" are required.

Today's Date:

Select Date

Personal Information

Last Name *:

First Name *:

Middle Name:

Nickname:

Street *:

City *:

State *:

Postal Code *:

Email Address *:

Home Phone *:

Emergency Contact:

Name:

Relationship:

Phone Number:

Your Date of Birth: (mm/dd/yyyy):

Your School:

Current Grade:

If under 15 years old please provide information about your supervising adult

Adult Name:

Relationship:

Phone:

Do you have an after school job?:
Yes
No

Where?:

Do you have prior volunteer experience?:
Yes
No

Where?:

Why are you interested in becoming a Potter League volunteer?:

Tell us about your hobbies or special interests:

Tell us about your current pets:

If we asked your best friend what you are really good at, what would they say?: