2. First Name
3. Last Name
5. Date of Birth
   Date of Birth
6. Are you over the age of 18?

   1. Yes
   2. No

    If you are under the age of eighteen (18), please download this application and have the parent or legal guardian  sign under your signature in the Disclaimer Section.

8. Phone Number
9. Email Address
11. Address
13. City
14. State
15. Zip Code
17. Emergency Contact Name
18. Emergency Contact Relationship
20. Emergency Contact Phone Number
21. Alternative Phone Number
23. Current Education
    -- Select One --NoneCurrently Enrolled in High School High School CompletedCurrently Enrolled in College / UniversityCollege / University CompletedOther
24. Name Educational Institutions
26. Preferred Start Date
    Preferred Start Date
27. How many hours do you want to complete? (##)
28. In which department would you like to volunteer?
    -- Select One --Public HealthAnimal ShelterMain LibrarySouthmost LibraryParks and RecreationPoliceFireOther
29. Would you like to receive a message with future volunteer opportunities?*

    1. Yes
    2. No
31. Volunteer Availability & Preferences

    I am available to volunteer between 8:00 am to 12:00 pm on the following dates.

    1. Monday
    2. Tuesday
    3. Wednesday
    4. Thursday
    5. Friday
    6. Saturday
    7. Sunday
32. Volunteer Availability & Preferences

    I am available to volunteer between 1:00 pm and 5:00 pm on the following dates.

    1. Monday
    2. Tuesday
    3. Wednesday
    4. Thursday
    5. Friday
    6. Saturday
    7. Sunday
33. Volunteer Availability & Preferences

    I am available to volunteer after 5:00 pm on the following dates.

    1. Monday
    2. Tuesday
    3. Wednesday
    4. Thursday
    5. Friday
    6. Saturday
    7. Sunday
35. Why do you wish to volunteer with the City of Brownsville?
39. I have read and understood the volunteer policies and procedures of the City of Brownsville

    Access the full volunteer policies and procedures with the following link: https://www.brownsvilletx.gov/DocumentCenter/View/7831/Volunteer-Policies-and-Procedures

    1. Yes

    1. No

    1. Non-applicable (Under 18 years of age. Require parental consent))
41. I have read and understood the accident waiver and release of liability form. *

    I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL. 

    ACCESS THE ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM WITH THE FOLLOWING LINK

    https://www.brownsvilletx.gov/DocumentCenter/View/4793/Accident-Waiver-and-Release-of-Liability-?bidId=

    1. Yes

    1. No

    1. Non-applicable (Under 18 years of age. Require parental consent))
43. Photo Release

    As a Volunteer, I __________ grant permission to the City of Brownsville to use the visual depiction of me and/or my minor child(ren) for the purpose of training, advertising, publicity and promotion of the City of Brownsville. I affirm the use of my and/or my minor child(ren)’s appearance(s) and I agree to hold the City of Brownsville harmless from any and all liability which the City of Brownsville may incur as a result of my and/or my minor child(ren)’s appearance(s). 

    1. I DO

    1. I DO NOT
45. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
47. Electronic Signature
51. CRIMINAL HISTORY CHECK

    If you are under 18 years old select the option "Non-Applicable". The Brownsville Police Department conducts local criminal history checks covering from October 2005 to Present.  The  City of Brownsville also conducts a Sex Offender Check for all Volunteers. Processing time is three business days . Please, download the following forms and complete them. You will also require a photo ID (front and back pictures to run the checks). Our volunteer coordinator will contact you soon with instructions on how to submit them.

    FORMS: https://www.brownsvilletx.gov/DocumentCenter/View/9467/BPD-Criminal-History-Check-Form

    1. I AUTHORIZE the City of Brownsville to conduct a background check. Required to attach Picture ID (Front and back))

    1. I DO NOT AUTHORIZE the City of Brownsville to conduct a background check.

    1. Non-applicable (Under 18 years of age. Require parental consent))Do not attach a picture of your identification card.
53. Upload Identification Card Picture (Front Part)

    Examples: Driving License, State or Federal Issued Identification Card, Passport Card.

54. Upload Identification Card Picture (Back Part)
56. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
58. Electronic Signature
Leave This Blank:


60. 1. Receive an email copy of this form.
61. Email address

    This field is not part of the form submission.

62. Submit

* indicates a required field