Volunteer Application

If you agree with our mission and would like to engage in our work firsthand, please complete this application. The information you provide will be stored in confidence under the provisions of the Data Protection Act. Your completed form will be held securely and confidentially. Only authorized staff will have access to your information.

Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Birthday
Employer
Position
Any special talents or skills you have that you feel would benefit our organization?
Please indicate days available:(Hold CTRL to select multiple days)
Times available:
From To
Any physical limitations?
In case of emergency contact:
As a volunteer of our organization I agree to abide by the policies and procedures. I understand that I will be volunteering at my own risk and that the organization, its employees and affiliates, cannot assume any responsibility for any liability for any accident, injury or health problem which may arise from any volunteer work I perform for the organization. I agree that all the work I do is on a volunteer basis and I am not eligible to receive any monetary payment or reward.
Signature:*
Date:*
Date Format: MM slash DD slash YYYY

From	To