Application For Youth In Action

The Office of
Volunteer Services
links citizens with opportunities to share their time with city government. The office recruits, places, tracks and recognizes volunteers for their efforts.

Youth In Action Volunteer Form

Open to all interested youth who will be in the Columbia and Central Missouri area this summer.

All items in BOLD are required.

Name:
Address:		City:
State:		Zip:
E-Mail:		Education: (highest grade completed)
Phone:	(5738747104) Please include area code without spaces or dashes.
Please describe any physical limitations we should consider when placing you:
Please list any previous volunteer or community experience:
How did you hear about the Youth in Action Summer Volunteer Program?
Why do you want to be a part of this program?
Emergency Information: (In case of emergency contact:)
Name:		Relationship:
Home Phone:	(5738747104) Please include area code without spaces or dashes.	Other Phone:	(5738747104) Please include area code without spaces or dashes.
*By selecting "Continue" below, you are signify that you have read and agree to the following:* I understand that I am not an employee of the City of Columbia and that any duties that I perform are as a volunteer. I agree to abide by the procedures set forth by the City of Columbia for my assigned volunteer duties. I also understand that it is my responsibility to update any address, emergency, or other changes to the information on this form. I grant permission for photographs or video clips to be taken of me or my child during Youth In Action projects, and I understand that these pictures may be viewed by the public. I understand that Youth In Action is designed for people 12-15 years of age and that the applicant falls within this age range. Volunteers must receive permission from a parent or guardian before submitting this form. Please verify your information before selecting submit.