CarePartners Volunteer Registration Form
Please complete the registration form below. Following registration, you will be contacted to schedule your training.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Gender
*
Male
Female
Ethnicity
*
Caucasian
African American/Black
Hispanic
Asian
Native American
Other
List any languages spoken:
*
Email
*
example@example.com
What is your employment status?
*
Please Select
Employed full-time
Employed part-time
Retired
Unemployed
What is the name of your employer/former employer?
*
Does your employer/former employer participate with Dollars for Doers or any other volunteer match program?
Yes
No
I don't know
Would you like to receive updates on CarePartners' programs and events via our monthly e-newsletter?
Yes
No
Program you are interested in
*
Please Select
Common Ground
The Gathering Place
Dementia Day Center
Other
Enter the location where you would like to volunteer. If you are unsure of the location type unsure.
ie Trinty East UMC
Programs you are interested in
Please Select
Second Family (In-home volunteer support)
Enter the location where you would like to volunteer. If you are unsure of the location type unsure.
ie Christ the Good Shepherd Catholic
Check the boxes of the groups you're interested in volunteering with:
*
Persons Living with Dementia
LGBT Older Adults
Hispanic/Latino Older Adults
State Issued Identification is only required for Second Family Care Team Volunteers .
Please upload a copy of your state issued identification:
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Authorization to Background Check:
CarePartners completes a volunteer background screening on all volunteers to create and maintain a safe environment for our clients, volunteers and community partners. To be eligible to serve as a CarePartners’ Volunteer, this registration form must be completed and signed. CarePartners reserves the right to periodically screen volunteers.
Photo Consent Form:
By Signing below, I agree to participate as a volunteer in a CarePartners program and I am giving consent to photographs or videos being taken of me while participating. These photographs or videos may be used in print, film, online or social media by CarePartners and our partnering congregations without liability of any nature.
Please sign below:
*
STAFF ONLY: By initialing below, I confirm verbal consent has been given to assist with the completion of the form.
Communications:
I understand that by registering as a volunteer, I may receive emails about upcoming opportunities, program updates, and organizational news. I may opt out of non‑essential emails at any time by selecting “unsubscribe” in any message or by contacting admin@carepartnerstexas.org.
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