Sickle Cell Disease Foundation
Volunteer Application
The Volunteer Program focuses on the donation of time and talent and it provides for the development and administration of volunteers within all of the foundation’s programs and services.
Full Name
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First Name
Last Name
Gender
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Male
Female
Non-binary
Other
Date of Birth
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-
Month
-
Day
Year
Date Picker Icon
I am at least 18 years of age or older
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Yes
No
Street Address
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City, State, Zip
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Best Contact Phone Number:
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Format: (000) 000-0000.
E-mail
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example@example.com
Choose one:
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This is my first time volunteering for the Sickle Cell Disease Foundation
I am a returning/former volunteer for the Sickle Cell Disease Foundation
I am an active client of the Sickle Cell Disease Foundation
Emergency Contact
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Relationship
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Emergency Contact Phone Number
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Format: (000) 000-0000.
Do you have any physical handicaps or conditions preventing you from performing any type of activity?
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No
Yes
If yes, please list:
Please select the volunteer activities you are interested in participating in
Camp Crescent Moon
Walk-a-thon
Golf Tournament
Tutoring Youth
Support Groups
Santa's Workshop- Holiday Gift Wrapping
Any volunteer activity available!
Volunteer Experience
Please list the organization names that you have volunteered for in the past two years:
Please describe why you wish to be a volunteer for the Sickle Cell Disease Foundation.
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How did you hear about us?
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Education/Employment
Education Level
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Please Select
HS Diploma
GED
BA/BS
MS/MA
Other
Select highest level attained
Are you currently a student?
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Yes
No
If yes, status:
Full time
Part time
School
Current or Alma Mater
College Major
Name of Employer
Title/Position/Occupation
Number of Years at current employer
Personal References
Reference #1 Name, Phone, & Email
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Personal Profile
Have you ever been arrested for a criminal offense?
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No
Yes
Have you ever been convicted or plead guilty to a crime?
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No
Yes
Have you ever been convicted of or plead guilty to sexual misconduct?
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No
Yes
If you answered "yes" to any of the above, please explain:
I understand that I will be required to submit a copy of a government issued ID (Driver's license, passport, etc.) if I am selected to volunteer for the Sickle Cell Disease Foundation.
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Yes
I understand that I will be required to submit a background check if I am selected to volunteer for the Sickle Cell Disease Foundation.
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Yes
The information contained in this application is correct to the best of my knowledge. I authorize any references listed in this application to give you any information (including opinions) that they may have regarding my character and fitness for working with children. In consideration of the receipt and evaluation of this application by the Sickle Cell Disease Foundation, I hereby release any individual, youth organization, charity, employer reference, or any other person or organization, including record custodians, both collectively and individually from any and all liability for damages of whatever kind or nature which may at any time result to me, my heirs, or family, on account of compliance or any attempts to comply with this authorization. I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application.
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No
Yes
Thank you for your interest in volunteering for the Sickle Cell Disease Foundation.
We will follow up with you shortly.
Submit
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