Loudoun County Homepage PRCS Adult Volunteer Application
* indicate required fields

Thank you for your interest in volunteering for Loudoun County's Department of Parks, Recreation and Community Services. Please complete the application below. If you have any questions, please email Debra.Bressler@Loudoun.gov

*Last Name

*First Name

Middle Initial

Date of Birth in MM/DD/YYYY format (If under 18)

*Street Address

Apartment/Unit #

*City

*State

*Zip Code

*Preferred phone number (in ###-###-#### format please)

Secondary phone number (in ###-###-#### format)

*Preferred method of communication:

*E-mail Address

*Have you been convicted of a felony or misdemeanor other than a minor traffic violation?

If you answered yes to the above question, please see if the criminal conviction involves a barrier crime as defined by the Code of Virginia 63.2-1726 by clicking this link

If you have been convicted of a felony or misdemeanor other than a minor traffic violation, does the criminal conviction involve a barrier crime as defined by the Code of Virginia?

*Are you fulfilling court appointed community service hours?

If yes, how many hours do you need to complete and by what date?

*What attracted you to PRCS? What aspect of our work motivates you to seek to volunteer opportunities here?

*What have you enjoyed most about your previous volunteer work? About previous paid employment? (max 1000 characters)

*Please select any areas of interest






*Please select the ages groups that you are interested in working with.





*What is your availability for volunteering? (please select all that apply)





Emergency Contact Information. Please list 2 people who we can contact in the event of an emergency.

*Full name of 1st emergency contact

*Your relationship to 1st emergency contact

*Best phone number for emergency contact. (In ###-###-#### format please)

Alternative phone number for emergency contact. (In ###-###-#### format please)

*Please list the city that your 1st emergency contact resides in.

*Full name of 2nd emergency contact.

*Your relationship to 2nd emergency contact.

*Best phone number for 2nd emergency contact. (In ###-###-#### format please)

Alternative phone number for 2nd emergency contact. (In ###-###-#### format please)

If you have any medical conditions PRCS needs to be aware of, please describe here. (max 1000 characters)