City of Brownsville
Volunteer Application
Volunteer Eligibility Requirements
Must reside in the State of Texas within 90 days
Must be 16 years of age or older (with parental/legal guardian consent)
Need to submit valid Photo Identification (i.e. State ID, Driver’s License, Student ID)
Personal Data
Full Name: Date:
Last First M.I.
Address:
Street Address Apartment/Unit #
City State ZIP Code
Phone: Email Address:
* If you are under the age of eighteen (18), please have parent sign
Are you over the age of 18: under your signature in the Disclaimer Section along with parent
valid ID
Emergency Contact: Relationship: Phone:
Education
High School: Did you graduate? Yes No
College: Did you graduate? Yes No
Other: Did you graduate? Yes No
Availability & Preferences
Mon Morning Tue Morning Wed Morning Thu Morning Fri Morning Sat Morning Sun Morning
Mon Afternoon Tue Afternoon Wed Afternoon Thu Afternoon Fri Afternoon Sat Afternoon Sun Afternoon
Preferred Start Date: Preferred Number of Hours per day (Min 1hr a day): Select One
Do you have a Certain number of hours that you need to complete? Select One
If yes, please specify how many hours
Do you have a deadline to complete your volunteer work? Select One
If yes, when is the deadline?
Which Department would you like to volunteer with? Select One
If other, please specify
Why do you wish to volunteer with the City of Brownsville?
1
Background Information
In order to provide a safe environment for program participants, the City of Brownsville requires all volunteers over the age of 18
years old to undergo a background screening. Completion of a Brownsville Police Department Criminal History Check and
Authorization to Release Information are required for consideration as a City of Brownsville Volunteer.
Please complete the following information:
Since your 18th birthday have you been CONVICTED for ANY violation(s) of the law other than minor traffic offenses, or pled
NOLO CONTENDERE (No Contest) to criminal charges, even if adjudication was withheld? Yes No
If yes, please explain:
Note: Answering Yes to the above does not automatically disqualify you from a volunteer assignment
Disclaimer and Signature
I hereby certify that I have a sincere interest in obtaining a volunteer assignment with the City of Brownsville and that all the
answers to questions herein and all other information otherwise furnished are true and correct.
I understand that any incorrect, incomplete or false statement of information furnished may subject me to disqualification or
termination of a volunteer assignment at any time.
Signature: Date:
Parental Signature if under 18yrs old: Date:
Submit valid proof of Identification
HR Office Use Only
Received by: Date:
Approved Disapprove
HR Director Signature: Date:
