Trying to Make Change to Save Lives

Volunteer Form

If you are passionate about helping others in your community please complete the following form below.

Full Name


Your Email

Phone Number




Zip Code

What qualifications/skills/experience/education do you have that you believe would benefit our clients?

Have you volunteered before?

If yes, please briefly describe your volunteer experience.

Would you like to supervise other volunteers?

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?

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

Which days per week would you be available to volunteer?

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.

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