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D2S Volunteer Application
Thank you for your interest in volunteering with D.E.S.T.I.N.E.D. to Succeed, Inc.  We request the following information from you as an applicant for volunteering with our organization.  You must complete all portions of this application.  Items left blank may result in disqualification from consideration.  You will receive a response within 48 hours.
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Email *
First                           Middle                  Last Name *
Address *
City     State     Zip *
Phone *
Emergency Contact: *
Relationship: *
Emergency Contact Phone Number: *
Are you related to any youth or adult served by D2S or D2S employee? If yes, list name(s). *
Have you spoken with someone about volunteering at D2S? If yes, list name(s). *
D2S has many volunteer opportunities that may interest you.(Please check one department) *
Please state any other information that would be helpful in determining a good volunteer placement for you (type of volunteer work, ages of youth you most identify with, etc.) *
What day(s) would you be interested in volunteering? *
What kind of time commitment are you willing to make? *
What languages do you speak fluently? *
Please provide the names, addresses, and phone number of three references (2 of which are professional).  Do not leave any information blank. *
I authorize D.E.S.T.I.N.E.D. to Succeed, Inc. to investigate all statements in this application.  I also authorize them to conduct a background check to include a criminal record check (if I am 18 or older) and reference check.  I hereby acknowledge that I have read and understood the preceding statement. I understand that my picture/video may be taken for the media and/or public relations and allow these pictures to be used for media and/or public relations purposes unless I otherwise submit in writing to D2S. *
Signature & Date (Your printed electronic signature serves as your official signature):
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