Contact Information

Date of Birth*
State / Province*
Confirm Email*

Organization Affiliation

Complete this section if you are volunteering on behalf of an organization. Select your organization from the drop-down menu or enter it in the field below. 


Name of Organization

Volunteer Information

Staff / Volunteer*
  • Staff
  • Volunteer
Volunteer Availability
  • Monday
  • Tuesday
  • Wednesday
  • Thursday
  • Friday
  • Saturday
  • Mornings
  • Afternoons
  • Evenings
  • As Needed
Volunteer Interest Areas
  • General
  • After School Program
  • Friday Night Program
  • Art
  • Sports
  • Community Events
  • Summer Programs
  • Ability Camp (Pennsylvania)
  • Media / Technology
  • Fundraising
  • Social Media / Marketing
Why do you want to volunteer?
What do you hope to gain?
Relevant Experience
Personal References
Additional Comments

Emergency Contact

Please enter the name and phone number of your emergency contact.

Volunteer Emergency Contact Name
Volunteer Emergency Contact Phone

Anything Else?

Additional Comments

Security Code

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