Junior Volunteer Application
Name
*
First Name
Last Name
Preferred Name
*
Age
*
Birth Date
*
-
Month
-
Day
Year
Date
Social Security Number
*
Gender
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Phone Number
*
Please enter a valid phone number.
Secondary Phone Number
Please enter a valid phone number.
Primary Email
*
example@example.com
Secondary Email
example@example.com
School
*
Current Grade Level
*
Please Select
8th
9th
10th
11th
Current Cumulative/Grade Point Average
*
I am a
*
Please Select
New Volunteer
Returning Volunteer
First Parent/Guardian Name
*
First Name
Last Name
First Parent/Guardian Employer
*
First Parent/Guardian Phone Number
*
Please enter a valid phone number.
First Parent/Guardian Email
*
example@example.com
Second Parent/Guardian Name
First Name
Last Name
Second Parent/Guardian Employer
Second Parent/Guardian Phone Number
Please enter a valid phone number.
Second Parent/Guardian Email
example@example.com
Please upload the completed parental consent form (see website).
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload the completed school reference form (see website).
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload school transcript.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload immunization records, including proof of COVID-19 vaccination.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: