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Volunteer Registration
Please apply only if you think you are responsible enough and will be committed.

Your Information
   
First Name:* Last Name:*
Age:*      
  Month Day Year  
Date of Birth:*
 
 
19
 
Address:* City:*
    Postal Code:*
Telephone:* Cell phone:
Email:*
   
School:* Grade:*
   
I consider myself:*
         
         
Additional Information
         
Mother's Name:*   Title:
Mother's Cellphone:   E-mail:
         
Father's Name:*   Title:
Father's Cellphone:   E-mail:
Religion:*      
   
I understand that to receive a signature on a Community Service form I must send in a weekly email about my visits.
         
         
Medical Information
       
Emergency Contact Name (other than a parent):* Phone:*
Relationship:* Cellphone:
 
Please list any allergies:*
       
Please list any medical conditions that we should be aware of:*
 
         
Parental Consent
         
This section must be approved by a parent before proceeding to the completion of the form.
   
I give my teen permission to volunteer in the Friendship Circle.
I give my teen permission to attend Friendship Circle trips.
I agree that my teen’s photos may be used for any and all Friendship Circle publicity purposes.
         
         
I would like to volunteer for:
         
     
 
When would you like to volunteer at a special needs child’s home?
1st choice      
Day of the week: Time:
       
2nd choice      
Day of the week: Time:
 
Do you have a friend with whom you'd like to volunteer? Yes No
If yes please provide your friend’s name:
Are your parents available to drive you to or from a child’s home? Yes No
   Volunteer Opportunities  
Friends at Home
Community Adventures
Get Moving
You are what you Eat
    Please specify:
 
 
 
 
I agree to keep all information about my circle friend and their family confidential.
In the event that I am unable to volunteer I will try to find another day to substitute and I will call my special friend in advance.
In the event that I am unable to attend Bowling League I will try to find a substitute volunteer and I will call the office in advance.
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