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Volunteer Prescreening Form

Thank you for your interest in volunteering with us! Please complete the form below so we can learn more about you and match you with the right opportunities.
PERSONAL INFORMATION
Name

First NameLast Name
Phone Number

Area CodePhone Number
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
AVAILABILITY
Days Available (check all that apply):
Preferred Times
Are you looking for a one-time opportunity or ongoing involvement?
INTERESTS AND SKILLS
What type of volunteer work are you interested in? (Check all that apply)

Other
Please list any relevant skills, training, or certifications
BACKGROUND INFORMATION

(All information is confidential and used only to ensure the safety of our volunteers and those we serve.)
Are you willing to undergo a background check?
Are you able to obtain a level 1 Fingerprint Clearance card?
Do you have any physical limitations or medical conditions we should be aware of?
If yes, please explain
FINAL QUESTIONS
Why do you want to volunteer with us?
How did you hear about us?

Other
Consent

I certify that the information provided is true and complete to the best of my knowledge.

I understand that this is a prescreening form and that additional steps (such as an interview or orientation) may be required.
Signature
Date

MonthDayYear
Date
Please verify that you are human
Should be Empty:

Volunteer Prescreening Form