Volunteer Form

Full Name

Age

Your Email

Phone Number

Address

City

State

Zip Code

What qualifications/skills/experience/education do you have that you believe would benefit our clients?
Clerical/Office Machines Computer Programming Public Speaking Research Supervision Teaching Working with People Writing/Editing Other 

Have you volunteered before? YesNo

If yes, please briefly describe your volunteer experience.

Would you like to supervise other volunteers? YesNo

What are some of your objectives for working as a volunteer?

Please describe any physical limitations that may influence your volunteer work activities.

Which months would you be available for volunteer work?
January February March April May June July August September October November December 

How many hours per week would you be available to volunteer?

Which days per week would you be available to volunteer?
Monday Tuesday Wednesday Thursday Friday 

Security Code:

Enter Security Code

Notice to Volunteer: Volunteers are not considered to be Federal employees for any purpose other than tort claims and injury compensation. Volunteer service is not creditable for leave accrual or any other benefit. However, volunteer service is creditable work experience.

Privacy Act: Following information is provided to comply with the Privacy Act (PL 93-579). The data will be used to contact applicants and to interview, screen and select them for volunteer assignments. Furnishing this data is voluntary.