Date:
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MM
DD
YYYY
How did you hear about our organization?:
Legal Name:
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First Name
Last Name
Preferred Name and Pronouns:
*
Is it safe to address you by your preferred name and pronouns in all settings? (ex. Phone call, in front of caregivers, etc.):
*
If no, please explain:
Address:
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone:
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(###)
###
####
You have my permission to:
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Email:
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Preferred Contact Method:
Do you have any special interests or skills you would like to share?:
What makes you uniquely you?:
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Are you a citizen of the United States? (This will not effect your volunteer eligibility):
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Do you have identification such as a driver's license, passport, state or school ID?:
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Are you licensed, capable, and insured to operate a motor vehicle?:
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Have you ever been refused work within a youth program?:
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If yes, please explain:
Have you ever been convicted of a felony?:
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If yes, please explain:
Are you willing to undergo a background check?:
*
If no, please explain:
Education Level
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Completion Status:
Major, Vocational Skill, or Degree Pursued:
Volunteer Time Preference (Please check all that apply):
Please write any specific time preferences here:
Please provide the name and contact information for three references. These can be a school counselor, someone you may have babysat/nannied for, a professional colleague, a teacher, or trusted adult who can verify your information and character:
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At The Prideful Path Project, we believe everyone has the ability to succeed. If there is something you feel may assist you on your volunteer path, please explain below and we will do our best to provide accessible options and limit triggers/distractions that may interfere with your success. This can be assistance with transportation, a sensory need, or even just a snack to start your shift. We’re all ears:
Finally, why do you want to volunteer with our organization?:
I certify that all of the information in this form is accurate and true to the best of my ability.
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I understand that if selected, I will undergo a background and reference check to ensure the safety and wellbeing of all who participate in The Prideful Path Project.
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If selected, I consent to attend a mental health and CPR/AED training at no cost to me, in person and/or via zoom.
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