Volunteer Application

Name
Name
If you have changed your name.
Date of birth:
Date of birth:
Please specify your ethnicity.
Preferred Phone Number: *
Preferred Phone Number:
Please include zip code.
Please include city, state and zip code.
Please include if full-time or part-time.
Emergency Contact *
Emergency Contact
Emergency Contact Phone *
Emergency Contact Phone
In the rare event you were to drive a PEARLS participant, we need the following information:
Type of volunteer assignment *
If looking for specific times during the day, please list that here.
If none, please note "none".
The above information is correct and complete to the best of my knowledge, without consequential omission of any kind. I understand that the agency will do a background check. I acknowledge that by completing that application the agency is not obligated to offer me a volunteer position. *