Volunteer Application

First Name

Last Name

Address

City

State

Zip Code

Primary Phone Number

Confirmed Email

Gender

Birthday

Are you over the age of 18?

Emergency Contact Name

Emergency Contact Phone

How did you hear about volunteering?

Who did you hear about volunteering from?

Facility you would like to volunteer at

What type of volunteer would you like to be? for description click here

What religion and/or denomination do you identify as?

If "Other" chosen please identify it below:

Will you be volunteering as an individual, or as part of a group, church or other organization?

What is the name of the group, church or other organization?

What do you want to do as a volunteer?

How many hours are you planning to visit our facility in a month

Have you been vaccinated? (Please note Signature does not require a COVID vaccine to volunteer)

List any Skills/Talents/Hobbies

When can you start?

Notes/Comments