Volunteer Application
Your Information
Sender
Date
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Cell Phone Number
Please enter a valid phone number.
May we text you at this number?
*
Yes
No
Home Phone Number
Please enter a valid phone number.
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
Male
Female
T-Shirt Size
Please Select
Small
Medium
Large
X-Large
XXL
XXXL
XXXXL
Are you currently in or ever served in the U.S. Military?
Yes
No
Race - check all that apply
White
Black or African American
Native American/Alaskan Native
Asian
Native Hawaiian/Other Pacific Islander
Other
Ethnicity
Hispanic
Non-Hispanic
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Best Phone
*
Please enter a valid phone number.
Emergency Contact Relationship
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Your Interests
Programs in which you would be interested in volunteering?
*
Homebound meal delivery
Receptionist at CHEER Center
Fundraising
CHEERmobile Grocery Delivery
CHEER-A-Pet Visitation
CHEERful Notes Glee Club Singers
Non-Emergency Med Transport.+-
Data entry
Kitchen helper
Phone-A-Friend Phone Contact
Special Event Staffing
Fitness Center Assistant
Other
Do you have your own transportation?
*
Yes
No
Do you have 4-wheel drive transportation?
Yes
No
Days available: (Check all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Other
Best time:
Mornings
Afternoons
Evenings
Other
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Details
Have you ever been charged with, convicted of, or plead guilty to a crime?
*
No
Yes
Please explain in detail your charges, including what it was for, and the date, and the consequences (Incarceration, probation, community service, etc.).
Do you have any community service requirements?
*
No
Yes
Community Service Details:
I am required to complete community service for school, church, social club, etc.
I am required to complete court mandated community service
Please explain court mandated community service. Include ORIGINAL charge, required number of hours, etc.
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Last Question
Be sure to click submit at the bottom of this page
Do you have any questions for us, or anything else you would like us to know about you?
Submit
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