Volunteer Application


 

1. Volunteer Profile Application

Please complete all areas.

Contact Details
BIO
Person to Contact in Case of an Emergency
2. Education
3. Employment
4. Volunteerism
5. Interests
6. Availability
7. Arrest Information

Note: An arrest does not automatically prohibit volunteer acceptance into a volunteer positions.

Arrest Details

If yes, complete the following.

Have you ever been incarcerated in a correctional/detention facility?
8. Agreement and Signature

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

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Española

Administrative Office

(if you are seeking information on Child and Family services in Española, please refer calls or fax referrals to Espa
ñola Early Childhood Services Center numbers below-
Thank You!)

102 N. Coronado
Espanola, NM 87532
phone 505.629.1813
fax 505.747.0421

Española Early Childhood Center

404 Hunter Street
Española, NM 87532
phone: 505.753.4123
fax: 505.753.6947

For referrals, ask to speak to Rebecca Quintana at ext 129

Adult Services

104 N. Coronado
Española, NM 87532
phone: 505.747.4715
fax: 505.747.4524

TTY/TDD/Audio Relay 711 National Voice Relay available:
Dial 711 to be automatically connected to a Telecommunications Relay Service operator who can initiate a call from any telephone, anywhere in the United States.

Santa Fe

Santa Fe Early Childhood Center(including Family Infant Toddler/Early Intervention)

1911 Fifth St., Suite 100
Santa Fe, NM 87505
phone: 505.955.0410
fax: 505.955.8577

Los Alamos
(Adult Home)

2056 Peach Street
Los Alamos, NM 87544
phone: 505.662.4703 [Women’s Apartment]
phone: 505.662.7653 [Men’s Apartment]

Chama Office

493 Terrace Ave., Suite 1
Chama, NM 87520
phone: 575.795.4681 or 575.209.0347

Taos Office

1332 Gusdorf Rd., #A
Taos, NM 87571
phone 575.224.3197
fax: 575.224.3198

Locations and Directions