Volunteer - Adult Application

Volunteer Application

First Name:
Contact Information

Last Name:

Nickname:

Address:

City:

State:

ZIP Code:

Home Phone:

Work Phone:

Cell Phone:

Email:

Demographic Information
You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.
Date of Birth:

Age Range*:

What gender pronoun do you prefer?:

Employer Name:

Work Phone:

Emergency Contact Information
This information is confidential and will be used only in the event you require assistance. It will not act as a condition of your acceptance into the volunteer program. In the case of injury, SCRAP has limited liability insurance that covers volunteers.
Emergency Contact Name:

Relationship:

Primary phone:

Secondary Phone:

Medical Information
Do you require any special accommodations in your work area? (If so, please describe):

Do you have any medical conditions we should know about? (If so, please describe):

Availability
Please indicate the days and times you are usually available to volunteer.
11am - 2pm
Sunday 11am - 2pm:

Monday 11am - 2pm:

Tuesday 11am - 2pm:

Wednesday 11am - 2pm:

Thursday 11am - 2pm:

Friday 11am - 2pm:

Saturday 11am - 2pm:

2:30pm - 5:30pm
Sunday 2:30pm - 5:30pm:

Monday 2:30pm - 5:30pm:

Tuesday 2:30pm - 5:30pm:

Wednesday 2:30pm - 5:30pm:

Thursday 2:30pm - 5:30pm:

Friday 2:30pm - 5:30pm:

Saturday 2:30pm - 5:30pm:

Other Information
How did you hear about SCRAP?:

Why would you like to volunteer at SCRAP?:

Interests and hobbies (What interests you? What do you like to do?):

Skills (e.g. organizing, people skills, etc.):

Criminal Background Check
While not all volunteers will be asked to have a criminal background check, all volunteer applicants are expected to agree to one. If you have been convicted of a felony, you will not automatically be disqualified from volunteering. However, if you do not disclose it, you will be disqualified.
I agree to authorize a Criminal Background Check if I am requested to do so*::

SCRAP Volunteer Waiver Agreement
I hereby acknowledge that I have read, understand and agree to all of the guidelines and agreements listed in the SCRAP Volunteer Waiver::