Volunteer Application

Contact Information

First Name:
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:
Home phone:
Work Phone:
Cell 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:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
2:30pm - 5:30pm
Sunday:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

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*:
Select:

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::