Connect Thru Cancer Volunteer Application

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Thank you for your time and efforts in helping us support individuals and families with cancer. Adults (18 or older) who wish to volunteer for the In-Home Program must provide PA State Child Abuse Clearances. The In Home Opportunities are limited. Group volunteer opportunities are offered in December to wrap our Secret Santa Gifts and 1-2 times during our Cancer Comfort Kits fills.

Name *

Age (Must be 18 or older for In Home) *

Address *

Phone (mobile) *

Email *

Current Employment or School Status: *

Work Experience: *

Volunteer Experience: *

Reference Contact Name/Title/Email *

Special Skills or Training

Areas of Volunteer Interest (please check all that apply) *

In Home Visits (limited opportunities)

Cancer Connect Program (weekend daytime, monthly events)

Event Support (Fall Fashion Show, Golf Outing)

Community Outreach Support ( Working with schools or business)

I want to organize a game/tournament with. my school or team (Spike ball, Basketball, Dodgeball, etc.)

Other:

Required

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