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My Volunteer Account
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Password:
 
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Volunteer Registration

Create a Volunteer Account
Please complete the form below by entering in your information. Once you have registered as a volunteer, you will be able to sign-up for volunteer opportunities with member agencies.

Fields marked with a * are required
Contact Information
*First Name:
     *Last Name:
*Date of Birth:
   
*Address:
*City:     *State:     *Zip:
       
*Home Phone: (999-999-9999)
     Cell Phone: (999-999-9999)
*Email: (used as username)
Employment/Education
Employer Name:
Education Level: (completed)
Volunteer Information
Do you have foreign language speaking ability you would like to use
in your volunteer service? (check all that apply)
   French
   German
   Other
   Polish
   Russian
   Spanish
Special Skills/Hobbies:
*Previous Volunteer Experience:
  Yes          No
If so, please describe:
*Time Commitment:
*Days Available:
 M     T     W     Th     F     Sa     Su
*When do you prefer to volunteer?
  Weekday mornings        Sunday morning
  Weekday afternoons        Sunday afternoon
  Weekday evenings        Sunday evenings
  Saturday morning        Saturday evenings
  Saturday afternoon           
Suburb or Zip Code where you would prefer to volunteer:
*Areas of Interest - check all that apply:
Animals     Arts     Children/Youth     Crisis/Disaster
Disabled     Elderly/Seniors     Environment     Fav Cause
Healthcare     Homeless     Politics     Skill Based
Summer/Holidays     Women in Need      
*Would you like a volunteer coach to contact you?
  Yes          No
If yes, preferred method of contact:
Security Information
*Password: (must be at least 8 characters)
        *Re-Type Password: