Contact Information

Full Name: (required)


Address: (required)


City: (required)


State: (required)


Zip Code: (required)


Home Phone: (required)


Work Phone: (required)


E-mail: (required)



Availability
During which hours are you available for volunteer assignments? (Note: You can check more then one).

Weekday mornings
Weekday afternoons
Weekday evenings
Weekend mornings
Weekend afternoons
Weekend evenings

Interests
Tell us in which areas you are interested in volunteering.
(Note: You can check more than one).

Administration
Events
Field Work
Fundraising
Deliveries
Phone bank
Newsletter production
Volunteer coordination

Special Skills or Qualifications
Summarize special skills and qualifications you have acquired from employment, previous volunteer work. or through other activities, including hobbies or sports.

Type here

Previous Volunteer Experience
Summarize your previous volunteer experience

Type here

Person to Notify in Case of Emergency

Full Name:


Address:


City:


State:


Zip Code:


Home Phone:


Work Phone:


E-mail:

Agreement
By submitting this application by clicking on the submit button, I affirm that the facts and information set forth are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

Our Policy
It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.

Thank you for completing this application form and for your interest in volunteering with us.

-Emergency Rights Inc.