Printer Friendly Volunteer Form - Executive Service Corps of Washington

PERSONAL DATA

Full Name __________________________________________________________	Address __________________________________________________________
Email __________________________________________________________	City __________________________________________________________
Birthday __________________________________________________________	State Zip __________________________________________________________
Home Phone __________________________________________________________	Cell Phone __________________________________________________________
Work Phone __________________________________________________________	Fax __________________________________________________________

EXPERIENCE

Retired? Yes ___ No ___	Presently Employed? Full-time ___ Part-time ___
Retirement Date __________________________________________________________	Employer __________________________________________________________
Availability for volunteering Times of the Year? __________________________________________________________	Days of the Week? __________________________________________________________
Nonprofit and Volunteer Experience Organization 1 __________________________________________________________ Tenure __________________________________________________________ Activities __________________________________________________________	. Organization 2 __________________________________________________________ Tenure __________________________________________________________ Activities __________________________________________________________
Organization 3 __________________________________________________________ Tenure __________________________________________________________ Activities __________________________________________________________
Most Recent Position Company __________________________________________________________ City/State __________________________________________ /_______ Title __________________________________________________________ Length of Service __________________________________________________________ Areas of Responsibility __________________________________________________________ __________________________________________________________ __________________________________________________________	Prior Position Company __________________________________________________________ City/State __________________________________________ /_______ Title __________________________________________________________ Length of Service __________________________________________________________ Areas of Responsibility _______________________________________________________________ _______________________________________________________________ _______________________________________________________________
References Please provide names and phone numbers of two references. Name __________________________________________________________ Phone __________________________________________________________	. . Name __________________________________________________________ Phone __________________________________________________________

OTHER INFORMATION

Please provide any other information which will help ESC know you better. (e.g. Publications, honors and awards, association memberships, military experience, hobbies, foreign languages, special interests, etc.)

__________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________________

Most requests for assistance from nonprofit organizations fall into the general areas shown below. If you are qualified and also have an interest in consulting in any of these areas, please check appropriately.

STRATEGIC PLANNING		FINANCIAL PLANNING/CONTROLS
___	Mission Statement Development	___	Accounting/Auditing
___	Goal and Objective Setting	___	Reporting and Controls
___	Feasibility Studies	___	Budgeting
___	Program Evaluation	___	Payroll
BOARD DEVELOPMENT		OPERATIONS AND SUPPORT
___	Assessment/Evaluation	___	Retail Store Management
___	Staff and Board Relations	___	Small Business Management
MARKETING		HUMAN RESOURCES
___	Market Research and Strategies	___	Personnel Policies and Practices
___	Marketing Plans	___	Compensation and Benefits
___	Advertising and Promotion	___	Employee Relations
PUBLIC RELATIONS		___	Training Development
___	Public Relations Strategies and Plans	___	Team Building
___	Media Relations	___	Volunteer Development and Utilization
___	Public Opinion Studies	___	Performance Planning; Appraisal
___	Newsletters and Brochures	___	Staffing (Recruiting/Placement)
___	Writing/Editing	FUNDRAISING
ORGANIZATION		___	Fundraising Strategies
___	Organization Evaluation	___	Feasibility Studies
___	Organization Planning/Design	___	Capital / Annual Giving Campaigns
___	Mergers	___	Fundraising Events
___	Management Controls
___	Business Plans
___	Start ups

SKILLS & INTERESTS

Will you consider projects outside of the greater Seattle area : (Check one)

Yes ___ No ___

Please indicate any preferences you might have as to type of nonprofit organization:

___	Arts	___	Government
___	Social Services	___	Environment
___	Health Care	___	No Preference
___	Education	___	Other: __________________________________________

Please tell us why you would like to volunteer with ESC:

Thank you very much!
We will be contacting you soon to schedule an interview.

Please print this form and return to:
Executive Service Corps
510 - 2nd Avenue West
Seattle, WA 98119

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