Volunteer Application

Volunteer Application
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth

MonthDayYear
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Photo Release: The Clearinghouse has my permission to use general information and/or photos about my volunteer work for promotional purposes for their programs and services. Please sign if you agree.
Areas you would be interested in volunteering:

Fundraising EventsCounting DonationsStocking ShelvesDate and bag donationsUsher Clients through the pantryFront Desk Client greeterData EntryFiling and copyingAdministrative TasksDonation pick up (ideal for someone with a truck or van)Assist at clothing outletHelp bag Sacks of SnacksWarehouse Deliveries and organizationHoliday Dinner DistributionsHelp With FundraisingOther
Emergency Contact:

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
By Signing this form I am attesting all my information is true and accurate:
Date

MonthDayYear
Date
Should be Empty: