Volunteer Application

Volunteer Application

Please complete the form below to so the volunteer coordinator can contact you and discuss options for getting involved.
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email Address*
Phone Number*

Area CodePhone Number
How did you hear about volunteer opportunities at IHI?*
Are you responding to a specific volunteer opportunity?*

YesNo
If Yes, which one:
Interested start date*

MonthDayYear
Your current occupation:*
Current employer or school:*

When are you available to volunteer? (days of the week, time of day, frequency?)*

	Monday	Tuesday	Wednesday	Thursday	Friday	Weekends	Special Events
Mornings
Afternoons
Evenings
Regularly
Occasionally
Special Events only

Can you commit to volunteering for at least three months?*

YesNo
As a volunteer, what special skills and life experiences will you bring to our organization?*
What kind of professional or personal experience do you hope to gain as a volunteer?*
Please mark the type of volunteer opportunities you are interested in:*

Medical office/Administrative Support (filing, light cleaning, organizing,etc...)Fundraising/In-Kind Donations (all skill levels welcome, small and large fundraising campaigns will always be in need of support)Teaching a class or hosting a support group (arts, fitness, cooking, etc)Special Events - planning or helping on day-of (i.e. annual fundraising event or other community outreach events)Group projects: planning and execution of community eventsTutoring or one-on-one coaching (e.g. computer skills, literacy skills)Specialized skills (graphic design, accounting, legal services, translation/interpretation, landscaping, etc)Social Media content creatorOrganizing a supply driveOther
Any physical limitations?
Are you volunteering to fulfill a program hours requirement or service learning hours? If so, please elaborate.*
Background Check
Have you ever plead guilty to or been convicted of any criminal offense? If so, please explain. A conviction may not necessarily bar you from volunteering.*
Are you pursuing mandated court service hours?*
If yes to the above question, how many hours?
Case Number:
Scheduled completion date:

MonthDayYear
Date
How long have you resided in Washington State?*
I hereby authorize Inside Health Institute to perform a background check and investigate any public records relating to my criminal history or lack thereof. IHI will use this record only in making the initial volunteer engagement decision and will not further disseminate the record.

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 and Date:
Please scan, photocopy, or take a picture of your Washington State Driver's License and include it with your application so we can verify your identity, or provide your driver's license during your interview.
Take Photo
Should be Empty:

Volunteer Application

Background Check