Community Service Volunteer Application
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4Goodwill Industries of Akron
Community Service Volunteer Application
Please make sure that all items are completed.
General Information:
Name_________________________________________________
Date_____________
Address__________________________________________________________________
City___________________________State__________ZIP________County____________
Phone__________________________E-Mail_____________________________________
Complete Date of Birth_____/______/_______ Previous Residences: Include City, State, County
______________________________________________________________________________________________________
____________________________________________________________________________________________________
Have you ever been convicted of a misdemeanor or felony? Yes____ No_____
(Other than a minor traffic violation)
If yes, please provide date(s) & details for all convictions, regardless of how much time has
passed _______________________________________________________________
_________________________________________________________________________
Answering “yes” to this question will not necessarily bar you from an opportunity to complete community service with Goodwill.
Name of Court__________________________________ Number of hours needed______
Case Number______________________________________ Deadline________________
Last 4 SSN # _______ - ____ - ________
(Last 4, full Social Security # will be needed for BR check, see page 4)
It is required that a copy of your court ordered community service document is returned with this
application. Any applications returned without it will not be processed.
I have included a copy of my court ordered community service. Yes_____ No______
(Application will not be processed until court documents are received)
Date(s) available to volunteer______________________________________________
Times available to volunteer: Please see reasonable time frames on third page.
DAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
SUNDAY
FROM
TO
Location(s) of interest for volunteering (check all that apply):
Akron Store
Ashland Store
Brunswick Store
570 E Waterloo Road
1611 Claremont
1733 Pearl Road
Northfield
Kent/Ravenna Store
Lakemore Store
10333 Northfield Road
2528 State Rt. 59
1500 Canton Road
Mansfield Store
Medina Store
Outlet Store
2140 W. Fourth St.
3500 Medina Road
1400 S Arlington Road Suite 150
Streetsboro Store
Tallmadge Store
State Road Store
1703 State Rt. 303
15 Midway Plaza
1725 State Road, Cuyahoga Falls
Twinsburg Store
Wadsworth Store
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/A GOODWILL® BOUTIQUE/
10735 Ravenna Road
170 Great Oaks
118 E. Main Street, Kent
LIMITED AVAILABILITY**
**MUST OBTAIN SPECIAL PERMISSION FROM VP of CONTRACTS/STORE MANAGER via Volunteer Coordinator
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