RCIS Volunteer Application

Thank you for your interest in volunteering with The CARE Healing Center, formerly known as RCIS. We are looking for individuals who are passionate about making a difference in survivors' healing in Carroll County. Upon submission of your application, a CARE staff member will be in touch within 1 business week to discuss the volunteer process and next steps. If you have any questions, please call our office at

(410) 857-0900.
Today's Date*
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Date of Birth*
Are you over the age of 18?*

YesNo
What volunteer opportunities interest you?*

24-Hour HelplineHospital Accompaniment (Virtual)Hospital Accompaniment (In-Person)
Can you commit to volunteering for at least 1 year?*

YesNo
Can you commit to signing up for at least 4 shifts per month?*

YesNo
What days of the week would you typically be available to take shifts? (This allows us to have a rough idea of when you would be available throughout the month)*

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
When would you be available to take shifts? (This allows us to have a rough idea of when you would be available throughout the month)*

12:00AM-6:00AM6:00AM-9:00AM9:00AM-12:00PM12:00PM-5:00PM5:00PM-9:00PM9:00PM-12:00AM
Do you have a working computer/tablet/phone with a camera and microphone?*

YesNo
Do you have regular access to the internet?*

YesNo
What languages do you speak fluently?*

EnglishSpanish
Please list an emergency contact should a situation arise when you are volunteering:
Emergency Contact*

First NameLast Name
Emergency Contact Relationship*
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
The answers to the following six questions are kept completely confidential.
Have you utilized RCIS's services in the past?*

YesNo
If yes, how long has it been since you've utilized RCIS services?*
Have you ever been convicted of a crime other than a traffic violation?*

YesNo
If yes, please explain:
Do you have any pending court cases?*

YesNo
If yes, please explain:
Volunteer Experience
Do you have previous volunteer experience?*

YesNo
If yes, please fill out the following volunteer experience questions:
Volunteer Organization #1
Supervisor Name

First NameLast Name
Supervisor Email
example@example.com
Supervisor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Start Date
End Date
How did you hear about RCIS?*
Why are you interested in volunteering with RCIS?*
What talents, skills, or special knowledge do you have that you could utilize at RCIS?*
What do you hope to gain from being a RCIS volunteer?*
I hereby certify the information supplied on this application is true to my knowledge.
Signature*
Date*
Please verify that you are human*
A CARE staff member will be in touch regarding your application within 1 business week. If you have any questions or concerns regarding your CARE STAR volunteer application before then, please call us at (410) 857-0900. We look forward to working with you!
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