Volunteer Application Form
Kidney Donor Conversations, Inc. encourages participation of volunteers who support our mission.  The information on this form will help us find the most satisfying and appropriate volunteer opportunity for you.

Kidney Donor Conversations, Inc. is dedicated to informing groups and individuals about all types of kidney donation, and inspiring them to consciously choose their donation path.
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Email *
First Name: *
Last Name *
Address: *
City: *
State: *
Zip: *
Phone: *
Job History
Any special talents or skills you have that you feel would benefit our organization? *
Explain why you want to be a volunteer: *
Interests: *
Please tell us in which areas you are interested in volunteering.
Availability *
Please indicate days of the week you are available for volunteering.
Please indicate time of day you are available. *
How often do you want to volunteer? *
How long would you likely be volunteering with KDC? *
Name of person to notify in case of emergency (if volunteering for events):
Emergency contact phone number:
I do hereby give Kidney Donor Conversations, Inc., their assigns, licensees and legal representatives the irrevocable right to use my name, picture, photograph, portrait, visual likeness, or voice in all forms and media in all manners, including social media, photo, film, audio and video representations, for non-profit, public purposes, and I hereby waive any right to inspect or approve the finished product that may be created in connection therewith. I have read this release, and am fully familiar with its contents. *
Our Policy
It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual identy, age, or disability.
As a volunteer of our organization, I agree to abide by the policies and procedures of the organization.  I understand that I will be volunteering at my own risk and that the organization, its employees and affiliates, cannot assume any responsibility for any liability for any accident, injury, or health problem which may arise from any volunteer work I perform for the organization.  I agree that all the work I do is on a volunteer basis and I am not eligible to receive any monetary payment.
Signature: *
Date: *
Thank you for completing this application form and for your interest in volunteering with us!
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