SCORE-Erie Volunteer Application

Name:

Spouse's Name (optional):

Street Address:

City:

State:

Zip Code:

Primary Phone:

Email: (required)

Fax:

Social Security Number: (last 4 digits)

Briefly describe your professional business experience:

(Can email resume or bio to SCORE193@juno.com )

Are you currently working? Yes No
If 'Yes', Full-Time or Part-Time? Full-Time Part-Time

OPTIONAL: (This information is used for statistical purpose only)
GENDER: FEMALE MALE YEAR OF BIRTH:
RACE/ETHNICITY: Caucasian/White Black/African American
Hispanic American Asian American Native American or Alaskan American
Native Hawaiian or other Pacific Islander Other

Industry Experience List

Code	Industry Experience
51	Advertising
2	Aerospace
3	Banking
4	Buildings Maintenance
5	Business Services
6	Clothing Stores
7	Commercial Printing
8	Communications Equipment and Telephone
9	Computer and Data Processing Services
10	Computer and Office Equipment
11	Construction
12	Consulting
13	Electrical Equipment and Supplies
14	Electrical Goods
15	Electronic Components and Access
16	Engineering and Architectural Services
17	Export/Import

18	Gasoline and Service Stations
19	General Merchandise Stores
20	Hotels and Motels
21	HVAC
22	Industrial Engineering
23	Insurance Agents, Brokers, and Services
52	INTERNATIONAL BUSINESS
24	Legal Services
25	Life Insurance
26	Mailing, Reproduction, Stenographic
27	Manufacturer's Representative
28	Manufacturing
29	Mergers and Acquisitions
30	Metalworking Machinery
31	Nurseries and Garden Stores
32	Packaging
33	Paper Products and Art Supplies
34	Pension, Health, and Welfare Funds
35	Personal Credit Institutions
36	Personnel Supply Services
37	Photographic Studios, Portrait
38	Production Management
39	Public Relations
40	Publishing
41	Real Estate Agents and Operators
42	Research and Testing Services
43	Residential Building
44	Restaurants
45	Sales and Marketing
53	Security (Information)
54	Security (Physical)
46	Space Research and Technology
47	Special Trades Contractors
48	Wholesale Operations

Counseling Skill List

*Code*	*Counseling Skill*
1	Accounting, Accounts Payable
2	Accounting, Accounts Receivable
3	Accounting, Bookkeeping
4	Accounting, Business Software
5	Administration
118	Advertising
7	Agriculture
8	Appraisals, Valuing
9	Architecture
10	Automobile, After Market
11	Aviation/Aerospace
12	Banking
13	Bankruptcy
14	Benefits
15	Budgets
16	Building Materials
21	Business Plans and Strategies
17	Business, Information Systems
18	Business, Plans
19	Business, Taxes
20	Business, Turn-Arounds
22	Buying or Selling a Business
23	Cash Flow
24	Catering
25	Chemical Engineering
26	Communications
27	Computer, Hardware
28	Computer, Information Systems
29	Computer, Software
30	Construction
31	Consulting
32	Contractors
33	Customer Service
34	Dental
35	Design
36	Distribution
37	Education
38	Electrical Engineering
39	Electronics
40	Export/Import
120	Farmer
41	Financial Planning
42	Financing
43	Food, Fast Food
44	Food, Production, Food Industry
45	Food, Restaurants
46	Franchising
47	General Management
48	Government Contracts
49	Hotel Motel
50	Human Resources, General
51	Human Resources, Recruitment
52	HVAC
53	Importing
54	Industrial Engineering
55	Internet
56	Inventory Management
57	Labor Relations
58	Landscaping
59	Legal Services
60	Manufacturers' Representative
61	Manufacturing
62	Manufacturing, Packaging
63	Marketing, General
64	Marketing, Industrial
65	Marketing, International
66	Marketing, Market Research
67	Marketing, Merchandising
68	Marketing, Pricing
69	Marketing, Retail
70	Marketing, Trade Industry and Trade Shows
71	Mechanical Engineering
72	Medical
73	Negotiation, General
74	Negotiations, Contract
75	Nonprofit Associations
76	Operations
77	Paper-Pulp
78	People Counseling
79	Pharmaceuticals
121	Plumbing
80	Printing/Copying
81	Process Equipment
82	Product Development
83	Project Management
84	Promotion/Merchandising
85	Purchasing, Procurement
86	Quality Assurance
87	Quality Systems
88	Real Estate, General
89	Real Estate, Rental Income
90	Repair Business
91	Research and Development
92	Retail
93	Safety
94	Sales, Catalogs
95	Sales, Commercial
96	Sales, General
97	Sales, Government, Federal
98	Sales, Retail
99	Sales, State and Local Government Agencies
123	Security (Information)
122	Security (Physical)
101	Seminar, Production
102	Small Business Certification
103	Spanish Language Counseling
104	Start-Up
105	Strategic Plans
106	Systems Engineering
107	Textiles
108	Trademarks
109	Training
110	Transportation
111	Utilities
112	Warehouse Dist.
113	Waterproofing
114	Wholesaling, Jobber, Distributor

Please rank up to 6 areas of your Business Experience

Rank	Code	*Area of Industry* Experience**
1.
2.
3.
4.
5.
6.

Rank	Code	*Area of Counseling* Skills**
1.
2.
3.
4.
5.
6.

SCORE MEMBERSHIP GUIDELINES
SCORE suggests that candidates for Membership meet the following guidelines. Your chapter may have specific additional requirements.

Management, administrative, business ownership or professional business experience;
Knowledge of contemporary business practices;
Ability to relate to and communicate with SCORE's diverse client base;
Agree to complete forms necessary to maintain chapter and SCORE Association office records;
Commit to actively participate in chapter committees, operations and programs, national and chapter counselor training programs.

SCORE Members must also agree to conform to the SCORE Code of Ethics and Conduct, SCORE Association and chapter bylaws, rules and standards. Volunteers are required to annually sign the SCORE Code of Ethics and Conduct. Your chapter will provide you with a copy of these documents.

Individual Volunteer Agreement

"I agree to assist the chapter in the following tasks/activities"

Foreign Language Skills

English, Spanish, French, Russian, Italian, Japanese, Korean, Arabic, Hindi, Bengali, Portuguese, German, Tagalog, Vietnamese, Polish, Mandarin, Cantonese

Please check the chapter activities that interest you:
Administration Computer Counseling/Mentoring Fundraising Leadership Marketing Public Relations Recruiting Workshops Volunteer Development Other

STATEMENT OF UNDERSTANDING
I understand that SCORE has a 90-day provisional period, during which I will receive orientation and training and that my full participation as a SCORE Volunteer is contingent upon my satisfactory completion of this training.

I may withdraw my membership at any time upon written notice to the chapter chair. I understand SCORE may terminate my volunteer membership, for any reason at any time, with or without cause or advance notice.

Any material developed while in SCORE belongs exclusively to the SCORE Association unless otherwise agreed to by the SCORE Association and other party.

I certify that all of the statements on this application are true and complete to the best of my knowledge and belief.

Signature of SCORE Applicant_ Date _

Non-Discrimination Policy: It is the policy of SCORE to afford equal opportunities to all applicants for membership on the basis of individual qualifications, without regard to race, color, religion, gender, age, national origin, physical or mental disabilities unrelated to SCORE membership requirements.

After submittal of this form, we will be in contact with you for an interview.