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Family Resource Center Volunteer Application

  1. Family Resources Center Volunteer Application
    P. O. Box 188
    Rocky Mount, VA 24151
    Phone: 540-483-5088
    24 Hour Hotline: 540-483-1234
  2. Are you a U. S. Citizen?*
  3. Do you have a valid Virginia Driver's License?*
  4. Have you ever been convicted of a felony?*
  5. Have you ever been charged with assault and battery?*
  6. Are you a "survivor" of domestic violence?*
  7. Have you ever been homeless?*
  8. Do you speak a foreign language?*
  9. Check the type of volunteer work you are interested in. (choose all that apply)*
  10. Please put times on the days that you would be available to volunteer.
  11. Leave This Blank:

  12. This field is not part of the form submission.