LCHE YPO Interest / Volunteer Application

2022 Youth Peace Olympics Volunteer Application

Thank you for your interest in the Louisiana Center for Health Equity's youth initiatives. Please fill out this short application form to help us get to know you better.

2022 Youth Peace Olympics Calendar:

Name: *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
E-mail *
Approx. Age *

18-30 31-40 41-50 51 and above
Emergency Contact *

First Name Last Name
Emergency Contact Phone Number *

Area Code Phone Number
Present Employer *
If not presently employed, please type "NA".
Volunteer experience and/or training *
Hobbies, skills, and special interests *
Community affiliations (civic organizations, churches, clubs, etc.) *
Referred by (if applicable)

First Name Last Name
What are you hoping to receive from this opportunity?
Are you willing to undergo a background check?

Yes No
Reference phone number

Area Code Phone Number
As a volunteer of LCHE, I hereby agree to abide by its policies and procedures. I understand that I will be volunteering at my own risk and that the organization and its employees and affiliates cannot assume responsibility for any liability due to an accident, injury, or health problem which may arise from my performance. I agree that all the work I do is on a volunteer basis, and I am not eligible to receive any monetary compensation or reward. *

Clear
Application Deadline: April 8, 2022
Should be Empty:

2022 Youth Peace Olympics Volunteer Application