Give > Volunteer > Volunteer Registration Volunteer Registration Volunteer Registration Form Step 1 of 5 20% Name* First Name Preferred Name Last Name Last 4 SSN*Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email* Phone*Preferred Contact Method*EmailPhoneLeave Phone MessageNoYesGender*MaleFemaleTransgenderOtherDon't KnowRefusedBirth Month*Birth Day*Birth Year*Ethnicity*African-AmericanAsian-AmericanCaucasianHispanicNative-AmericanMulti-EthnicOther Emergency Contact Name First Last Emergency Contact PhoneEmergency Relationship Your Volunteer PreferencesAvailability* Select All Days Evenings Weekends Preferred Location* Select All Community Center (admin fundraising) Dental Health (dental services for HIV+ clients) Health Campus (client services, food pantry, hot meal program) Nelson-Tebedo (HIV/STD testing, transgender programs) Prevention Programs (UBE, Fuse) Volunteer Work* Select All Administrative/clerical, data entry Hot meals/food pantry Reception desk Cyber center Gaybingo Fundraising/special events Medical professional Other LimitationsEmployerExperienceCheck the following areas where you ALREADY HAVE training and experience Select All Artist ASL Computer Hardware/Software Cook Dentist Event Planning Graphic Production Health Educator Lawyer License Counselor Life Coach Medical Technician Nurse (LVN or RN) Performing Artist Photographer Physician Physician's Assistant Public Speaking Sales & Marketing Spanish Speaker Writer/Editor Community ServiceResource Center policy prohibits volunteer service from anyone convicted of a crime against a child and/or violent offense.Comminity Service*NoYesOffenseNoYesOffense DateHoursThe following must be provided before any community service work can be performedCourts ContactProbation officerAttorneyProbation Officer or Attorney Name First Name Last Name Probation Officer or Attorney Phone NumberCourt Case Number Confidentiality Policy* I have read and understand these confidentiality guidelines Volunteer Agreement* I have read and understand these volunteer agreement guidelines CommentsThis field is for validation purposes and should be left unchanged.
English
Spanish