Volunteer at the Valley Mission

Current Contact Information

Country*
Email*
Confirm Email*
Phone*

Additional Information

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Date of Birth*
State of Birth (Abbreviation)*
Please Enter any Previous Addresses for the Past 3 Years:*
If yes, explain:
What Days Are You Available to Volunteer:*
What Times Are You Available to Volunteer:*
Tell Us How You Want to Volunteer!*
Skills & Certifications*
Emergency Contact Name*
Relationship with Emergency Contact*
Emergency Contact Phone Number*

Releases & Agreements

If you select YES to these fields, you are agreeing to:

  • Permission for a Background Check: I give Valley Mission, Inc. the right to check my background and release from all liability or responsibility all persons or companies supplying information.
  • Confidentiality Agreement: I promise that I will not divulge any information that I may hear or see concerning any client, member of staff or volunteer of the Valley Mission.
  • Release from Personal Liability: I release the Valley Mission, Inc. and all of its employees from any personal liability.

By signing typing your full legal name in the "Signature" box below, you agree to the terms as defined above.

Signature*

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