Volunteer Application Form
Your Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Birth Date
*
-
Month
-
Day
Year
Date
Phone Number
*
-
Area Code
Phone Number
Do you need accommodation services in order to perform your duties?
*
Yes
No
Please enter what type of accommodation services do you need.
Emergency Contacts
Education Level
*
Please Select
High school diploma
Associates degree
Bachelors degree
Masters degree
Ph.D.
School Name
*
List Trainings or Licenses Completed.
Are you volunteering as a requirement for college credits?
*
Yes
No
If yes, explain your academic circumstance (specify hours required to complete).
How did you find this volunteering program?
*
Please Select
Brochures
Google
Facebook
Twitter
Instagram
Other
Availability Information
*
Rows
From
To
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Which areas are you interested in volunteering at Solutions:
Autism in Motion (AIM)
Other
Why do you want to be a volunteer in this program?
*
What are your interests/skills?
*
As a volunteer of Solutions Behavioral Healthcare Professionals, I agree to abide by the policies and procedures. I understand that I will be volunteering at my own risk and that the organization, it's 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 will track my own hours if necessary. I understand that if I am associated with a university and a part of a practicum experience, I need to provide a signed agreement from the academic department of which my volunteer requirement is associated with.
*
Yes
No
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