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Corrigan Care Volunteer Application
This application is the first step to volunteer with Corrigan Care's services.
First Name *
Your answer
Last Name *
Your answer
Street Address *
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City *
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State *
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Zip Code *
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Age *
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Email Address *
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Phone Number *
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Employer or College
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Job Title or Major
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How did you hear about Corrigan Care? *
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Please describe your experiences working with children with developmental disabilities. (experience not required.) *
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What days and times are you available to volunteer? *
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Which areas are you interested in volunteering in? *
Required
Are you willing to be contacted via text and email regarding urgent or last minute volunteer needs? *
Have you ever been convicted of, or charged with, a felony? *
If yes, please explain.
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Please list a professional reference (not family)
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Please list this reference's phone number.
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Please list this reference's relationship to you.
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Please list a second professional reference (not family)
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Please list this second reference's phone number.
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Please list this second reference's relationship to you.
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Please list an emergency contact. *
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Please list this contact's phone number. *
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Please list this contact's relationship to you. *
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I certify that all the information I have provided is true and I have never been charged or convicted with felony offense such as child abuse or neglect, child pornography, child abduction, kidnapping, rape or any other offense. I understand that Corrigan care, Inc. is not responsible for any injuries or damage to me and/or my personal property that may result from my voluntary involvement in their activities. I hereby discharge Corrigan Care, its directors, agents, and other volunteers from all claims, demands, and actions from such activities. I grant Corrigan Care permission to use any photographs, video or quotations from me during my involvement with Corrigan Care to be used to further promote Corrigan care, Inc. Furthermore, I realize that any sensitive family information that I become aware of during my voluntary participation is confidential and should not be discussed outside the bounds of Corrigan Care, Inc. Finally I understand that I am an 'at will' volunteer and can be terminated at any time. Electronic Signature follows: *
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