JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Community Service
Please fill out this form for court-order volunteer opportunities. Contact Cathy Huda at
chuda@sterlinghousecc.org
if you have any questions.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email:
*
Your answer
Date:
*
MM
/
DD
/
YYYY
First Name:
*
Your answer
Middle Name:
*
Your answer
Last Name:
*
Your answer
Address:
*
Your answer
Cell Phone #:
*
Your answer
Emergency Contact Name:
*
Your answer
Emergency Contact Relationship to you:
*
Your answer
Emergency Contact Phone #:
*
Your answer
Occupation/School:
*
Your answer
Education/Special Training:
*
Your answer
Skills/Special Interests:
*
Your answer
Previous Volunteer Experience:
*
Your answer
How did you hear about Sterling House for service hours?
*
Your answer
Probation Officer/Court Workers Name:
*
Your answer
What court do they work out of?
*
Your answer
Total hours needed to complete:
*
Your answer
Date to be completed:
*
Your answer
When were these hours assigned?
*
Your answer
Are these the total hours assigned by the court?
*
Yes
No
Required
What was the offense?
*
Your answer
Please list any previous arrests, convictions, misdemeanors, felonies, probation's, alias (if any), and pending cases:
*
Your answer
Availability (check all that apply):
*
Days
Afternoons
Nights
Weekends
At times, photos are taken of various activities to use on our social media and for other publicity. Please check below giving permission to use photos of you for these purposes.
*
Yes
No
Required
Signature:
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Sterling House Community Center.
Report Abuse
Forms
