HopeLink Volunteer Application

First Name *

Last Name *

Birth Date *

// (mm/dd/yyyy)

Email *

Phone Type *

Phone Number *

Address Type *

Address

City *

State/Province *

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? *

Please Explain

Volunteer Frequency *

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