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Volunteer Form
We would love to hear from you! Please fill out this form and we will get in touch with you shortly.
CONTACT INFORMATION
Name
*
First
Last
Email
*
Enter Email
Confirm Email
Mailiing Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
Home Phone
*
Cell Phone
*
I preferred to be contacted by – Check Preferred:
*
Home Phone
Cell Phone
Email
Text
I affirm that I am over the age of 18 (if under 18, parental permission will be required to volunteer. Some volunteer opportunities may not be available to minors.)
*
Yes
No
Have you ever volunteered with or used a United Through Reading Program?
*
Yes
No
Where:
*
When:
*
In what capacity:
*
Regional Volunteer
Active Duty Coordinator
Homefront Coordinator
Recorded DVD
Recipient of DVD
Types of Volunteer Activities I could perform:
*
Speaking in front of a large audience (50-150 people)
Speaking in front of a medium audience (15-50 people)
Speaking in front of a small group ( <15 people)
Answering questions at a table or booth
Graphics/publishing
Social Media (Facebook/Twitter/LinkedIn)
Event Planning (Storybook Ball)
Coordinating a Virtual Book Drive
Data Entry
Office Administration Work
Blogging
How did you hear about our volunteer opportunities?
*
What are your volunteer interests or goals?
*
Describe current/previous volunteer activities:
*
I am looking to volunteer
*
On an ongoing basis
One time only
I need to fulfill mandated volunteer service
*
Yes
No
If mandated, is to fulfill:
*
Community Service
Court Ordered
Internship/Work Study
School
If mandated, # hours mandated
*
Due by (date)
I am currently (check all that apply)
*
Volunteering
Employed outside the home
Seeking employment
A Student
Other
If "Other," please specify
*
EXPERIENCE
Starting with current/most recent
Organization #1
Position #1
At Organization #1, I was a(n):
Volunteer
Employee
Start Date #1 (approximate)
End Date #1 (approximate)
Organization #2
Position #2
At Organization #2, I was a(n):
Volunteer
Employee
Start Date #2 (approximate)
End Date #2 (approximate)
Organization #3
Position #3
At Organization #3, I was a(n):
Volunteer
Employee
Start Date #3 (approximate)
End Date #3 (approximate)
REFERENCES
Please list two people not related to you that we may contact as a reference
Reference #1 Name
First
Last
Reference #1 Address
Street Address
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
Reference #1 Phone
Reference #1 Email
How long have you known this person (Reference #1 ):
Reference #2 Name
First
Last
Reference #2 Address
Street Address
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
Reference #2 Phone
Refererence #2 Email
How long have you known this person (Refence #2 ):
Certification and Permission
*
Yes
No
I certify that all information on this form is true and complete. I give permission for United Through Reading to verify all information and authorize past employers/organizations/references to supply information and answer questions related to my connection with them
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