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HopeLink Volunteer Application
First Name
*
Last Name
*
Birth Date
*
/
/
(mm/dd/yyyy)
Email
*
Phone Type
*
Home
Mobile
Other
Work
Phone Number
*
Address Type
*
Home
Work
School
Other
Address
City
*
State/Province
*
Alabama
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Ohio
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Rhode Island
South Carolina
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Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
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American Samoa
Federated States of Micronesia
Guam
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Northern Mariana Islands
Palau
Puerto Rico
U.S. Minor Outlying Islands
Virgin Islands
Armed Forces Americas
Armed Forces Europe, the Middle East, an
Armed Forces Pacific
Alberta
British Columbia
Manitoba
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Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut Territory
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
Zip
*
Do You Represent a Company or Organization?
Company or Organization Name
Department
Title
Address 2
City, State
Zip Code
Business Phone
Website
Areas of Interest
Check all that apply to you
*
Administrative/Clerical
Fundraising Support
Back2School
Class Facilitation
Event Planning
Holiday Activities
Special Events
Wherever I'm Needed
Other Areas of Interest
Do you have any special skills or experience you think may be helpful to HopeLink?
Do You Have any physical Limitations?
*
Yes
No
Please Explain
Volunteer Frequency
*
Weekly
Monthly
By Event
Emergency Contact
Name
*
Relationship
*
Phone
*
CONFIDENTIALITY
A HopeLink volunteer shall keep all information confidential that is produced, prepared, observed or received by the volunteer, in whatever form, to the extent that such information is confidential by law.
INDEMNIFICATION
As a volunteer for HopeLink of Southern Nevada, I agree to idemnify and hold harmless HopeLink of Southern Nevada from and against all liability, claims, actions, damages, losses and expenses that may arise out of the performance of volunteer duties.
E-Signature
Today's Date
If volunteer is under age 18, a parent/guardian must sign below and complete the Minor Release Form, which you can complete
here
.
As the parent/guardian of the Volunteer Applicant named on this form, I grant my permission for him/her to participate as an unpaid volunteer for HopeLink of Southern Nevada.
Parent/Guardian E-Signature
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