CHAMP Volunteer Application

CHAMP Volunteer Application

Thank you for your interest in volunteering with Community Healing And Mental Health Project (CHAMP). Our volunteers are essential to helping us provide mental health awareness, community programming, and healing-centered services across Fort Worth.We are honored that you are considering serving alongside us.
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
Pefered shirt size *
What is your age group?*

Teen (under 18)Adult (18 or older)
Home Address *

Street Address

CityState / Province

Postal / Zip Code
Emergency Contact Name

First NameLast Name
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.

Background & Compliance
Have you ever been convicted of a felony?*

YesNo
Please explain
Are you willing to complete a background check if required?*

YesNo
Have you ever been involved in a situation involving child abuse or neglect?*

YesNo

Consent & Agreement
*

I understand that volunteering with CHAMP may require training and adherence to confidentiality policies.
*

I understand that submitting this application does not guarantee placement.
*

I certify that the information provided is accurate.
Signature*
Date*

MonthDayYear
Date
Should be Empty:

Volunteer Interest & Availability