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VOLUNTEER APPLICATION for the WEIRTON AREA PORT AUTHORITY, INC.
[Use <Tab> or Cursor to select fields. Hit <Enter> only when ready to Submit.]
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| VOLUNTEER INFORMATION |
| *Name: |
| *Mailing Address: |
*Best Time to Contact: |
| *City: *State: |
*Zip Code: |
| *Email Address: |
| *Phone Cell Home Work |
| Occupation/Industry: |
Employer: |
| Work Location: |
Title: |
| *Emergency Contact: |
Relationship: |
| *Emergency Phone Cell Home Work |
| SKILLS |
| *Do you reside or work within 40 miles of the Port's District? Yes No |
| *Reason for Volunteering: |
*Brief Experience Summary: (If resume available, email to info@wapainc.org)
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Special Skills/Talents:
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| Other Volunteer Experience: |
| Did you serve in the military? Yes No If Yes, specify: |
| Do you speak any foreign languages? Yes No If Yes, specify: |
| Do you work in the security field or hold a security clearance? Yes No |
| Have you had exposure to or utilized the global supply chain? Yes No |
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*Have you been convicted of a crime? Yes No If Yes, specify:
(Omit minor traffic offenses; sealed or expunged convictions; personal use marijuana convictions 2yrs or older & judicially dismissed misdemeanors.)
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| AVAILABILITY |
*Availability Options: Hours/Wk: Time: AM PM
Days: Mon Tues Wed Thurs Fri Sat Sun |
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Would you be willing to work on Committees or Working Groups: Yes No
(NOTE: Only 'Members' can participate at this level.)
Areas if Interest: Administration Finance Programs
Technology Security Regulatory
Public Relations |
| ADVISORY |
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Please be advised that the Port and its staff, including volunteers, must adhere to DHS, TSA & USCG port security requirements. An applicant’s criminal history may be checked to verify responses solely to ensure the safety of the Port and its personnel. No applicant will be denied volunteer status solely on the grounds of a conviction. The nature of the offense, date, circumstances, and relevance to the position will all be considered.
Port facilities will be secured with necessary security measures. All staff, including volunteers, must:
- Sign the DHS Non-Disclosure Agreement
- Sign the Weirton Area Port Authority Non-Disclosure Agreement
- May be asked to obtain a TWIC badge which requires a DHS background check
- Agree to and understand defined procedures required for secure Port operations |
| CERTIFICATION & SIGNATURE |
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“I certify that all information submitted by me on this application is true and complete. I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and active volunteer status may be terminated at any time. In consideration of my volunteer application, I agree to adhere to the policies and regulations of the WAPA Inc, and I agree that my volunteer status can be terminated, with or without cause, and with or without notice, at any time by WAPA Inc.”
By entering my name below, I am indicating my intent to electronically sign this volunteer application:
*Applicant Signature:
*Date: {mm/dd/yyyy format}
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