Franklin County Family Resource Center

Franklin County Virginia Family Resource Center and Shelter

How to Volunteer
Simply fill out this application and someone from
our office will be in touch with you shortly.

Today's Date:
Name:
Address:
Address:
City:	State: Zip:
e-Mail:
Home Phone:
Work Phone:
Cell Phone:
Date of Birth:	Current Age:
Are you a US citizen?	Do you have a valid VA driver's license?

How did you hear of the Family Resource Center Volunteer Program?
Have you ever been convicted of a felony? Yes: No:
Have you ever been charged with assault and battery? Yes: No:
Are you a "survivor" of domestic violence? Yes: No:
Have you ever been homeless? Yes: No:
Do you speak a foreign language? Yes: No:
If yes, what language do you speak?
Please indicate your education level.
High School: 9 10 11 Completed
College/University: 1 year 2 years 3 years Completed
Master's Degree: Present Completed
Do you have any special interests?
Please check the the type of volunteer work you are interested in. You can select more than one: Babysitting Transportation Women's Activities Children's Activities Emergency Contact Person Office Help
Please check the day(s) you are available and indicate a time frame .
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Franklin County Family Resource Center
PO Box 188 • Rocky Mount, VA • 540-483-5088 (TTY available)
cindytreadway@franklincountyva.org