Call: 1 (305) 603-7451 | Email: [email protected]
First Name (required)
Last Name (required)
Street Address (required)
City (required)
State (required) —Please choose an option—AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming
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Work Phone (required)
E-Mail Address (required)
Law Enforcement Officer: YesNo
Badge Number
Are You a Teacher/Principal? YesNo
School and Principal info:
During which hours are you available for volunteer assignments? (Select as many as you’d like) Weekday morningsWeekend morningsWeekday afternoonsWeekend afternoonsWeekday eveningsWeekend evenings
Tell us in which areas you are interested in volunteering: (Select as many as you’d like) AdministrationEventsField workFundraisingDeliveriesPhone bankNewsletter productionVolunteer coordination
Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.
Summarize your previous volunteer experience.
Emergency Contact Name (required)
Emergency Contact Address (required)
State: —Please choose an option—AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming
ZIP Code (required)
Emergency Contact Phone Number (required)
Emergency Contact E-mail Address (required)
By checking this box and submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. I agree to submit to a background check prior to contact with the youth.
Name (required)
Your Initials (required)
Date (required)
It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.
Thank you for completing this application form and for your interest in volunteering with us. Please email to [email protected] or fax to (305) 603-7451.
