Volunteer Interest Form

  • Date Format: MM slash DD slash YYYY
  • Please Check All That Are Applicable *A commitment of 1x/week for 6 months is preferred, but adjustments can be made regarding the number of days per week/month on an individual basis.
  • Please list three persons we may call who are NOT family, one of whom may be your religious or spiritual leader, teacher, employer or relationship other than personal friend.
  • Please list three persons we may call who are NOT family, one of whom may be your religious or spiritual leader, teacher, employer or relationship other than personal friend.
  • Please list three persons we may call who are NOT family, one of whom may be your religious or spiritual leader, teacher, employer or relationship other than personal friend.
  • Drop files here or
    Accepted file types: jpg, pdf, word.
    A document from a medical professional indicating the following: •The volunteer has been seen within the previous 12 months of the start date of volunteer activity. • Proof of a negative TB test, within the past 12 months. • A statement that the individual is Free of Sign and Symptoms of infectious diseases which may be transmitted to other participants and staff.
  • This field is for validation purposes and should be left unchanged.