Give > Volunteer > Volunteer Registration Volunteer Registration Volunteer Registration Form Step 1 of 5 20% Name* First Name What name do you go by? Last Name Last 4 SSN* Please ensure the last 4 digits you provide are correct.Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email* Phone*Preferred Contact Method* Email Phone Leave Phone Message? No Yes What pronouns do you use? (This helps us know how to address you!)* They/Them She/Her He/Him Decline to answer Gender* Male Female Transgender Male/Trans Man/Female-to-Male (FTM) Transgender Female/Trans Woman/ Male-to-Female (MTF) Nonbinary/Genderqueer, neither exclusively male nor female Questioning Decline to answer Date of Birth* MM slash DD slash YYYY Ethnicity*African-AmericanAsian-AmericanCaucasianHispanicNative-AmericanMulti-EthnicOther Emergency Contact Name First Last Emergency Contact PhoneEmergency Relationship Your Volunteer PreferencesAvailability* Select All Days Evenings Weekends Preferred Location* Select All Community Center (admin fundraising) Dental Health (dental services for HIV+ clients) Health Campus (client services, food pantry, hot meal program) Nelson-Tebedo (HIV/STI testing, PrEP access, Gender-Affirming Care) Prevention Programs (UBE, FUSE) Volunteer Work* Select All Administrative/clerical, data entry Hot meals/food pantry Reception desk Cyber center Gaybingo Fundraising/special events Medical professional Other Limitations Employer ExperienceCheck the following areas where you ALREADY HAVE training and experience Select All Artist ASL Computer Hardware/Software Cook Dentist Event Planning Graphic Production Health Educator Lawyer License Counselor Life Coach Medical Technician Nurse (LVN or RN) Performing Artist Photographer Physician Physician’s Assistant Public Speaking Sales & Marketing Spanish Speaker Writer/Editor Community ServiceResource Center policy prohibits volunteer service from anyone convicted of a crime against a child and/or violent offense.Community Service* No Yes Offense No Yes Offense Date MM slash DD slash YYYY The following must be provided before any community service work can be performedCourts Contact Probation officer Attorney Probation Officer or Attorney Name First Name Last Name Probation Officer or Attorney Phone NumberCourt Case Number Confidentiality Policy* I have read and understand these confidentiality guidelines Volunteer Agreement* I have read and understand these volunteer agreement guidelines NameThis field is for validation purposes and should be left unchanged.
