Star Equestrian Center
13674 Greencastle Pike
Hagerstown, Maryland 21740
(301) 791-6222

Application for Volunteer Services

How did you hear about us?

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Walk-in
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Applicant Information

Name (First/Middle/Last):
Address:
City:    State: Zip:
Phone #:    SS#:
Age: Under 15   16-30   31-45   46-60   61 or Over

Student   Retired   Homemaker   Unemployed   Employed

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? (proof of citizenship or immigration status will be required)

Yes   No
Have you been convicted of a felony within the last 7 years? (conviction will not necessarily disqualify an applicant) Yes   No
If yes, please explain:


Employment/Volunteer Experience

Employer:        Phone #:
Address:

Supervisor:        Your Job Title:
Work Performed:
Regular Working Hours:


Language Skills

Braille: Fluent   Good   Fair   None
Sign Language: Fluent   Good   Fair   None
Foreign Language: Fluent   Good   Fair   None


Training

Describe any specialized training, apprenticeship, skills, hobbies, and extracurricular activities:


Personal References

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Address:

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