Email Address:

Availability - during which hours are you available for volunteer assignments? (choose all that apply).

Weekday Mornings Weekday Afternoons Weekday Evenings

Interests - tell us in which areas you are interested in volunteering (choose all that apply).

Administration Events Fundraising Sharing Skills/Hobbies/Crafts

Tutoring Student Aide Miscellaneous

Person to Notify in Case of Emergency:

Name:

Street Address:

City/State/Zip:

Home Phone:

Work Phone:

Email Address:

Agreement and Signature

By submitting this application, I affirm that the facts set forth in it 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.

By submitting this application I am acknowledging and authorize New Priorities Family Services to perform a criminal background check.

If you are chosen to become a volunteer you will be required to sign and date this application at that time.

Our Policy

It is the policy of New Priorities Family Services 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.