Volunteer Application
Thank you for your interest in becoming a volunteer for BASE Camp!
Please submit the form below and plan to schedule a VOLUNTEER ORIENTATION @ our office in Winter Park! You will receive an email with more information to schedule your volunteer orientation in the coming days. We look forward to meeting with you soon and getting you scheduled to volunteer with us!
First Name *
Middle Name
Last Name *
Name you would like to be called, if different...
Gender *
Date of Birth *
Are you over the age of 18? *
T-Shirt Size *
Drivers License #
Permanent Address Line 1: *
Permanent Address Line 2: *
How long have you lived at this address? *
If less than 5 years, please provide previous address:
Email Address: *
Phone Number: *
Place of Employment: *
Position: *
Supervisor: *
Personal Reference Name: *
Please name one person unrelated to you, who is acquainter with your work, general qualifications, abilities and character. Be sure to include their correct address, phone number or email in order for us to contact them.
Personal Reference Contact: *
Address, E-mail or Phone Number
Do you authorize BASE Camp Children's Cancer Foundation to perform a background check and to contact your reference? *
Do you have any present of previous volunteer experience? *
Please list any special skills, training or education:
second language, Computer skill, child care, etc...
What type of volunteer opportunities are you currently interested in at BASE Camp? *
Are you a patient/sibling/child of a family member with a Hematological/Oncology Illness? *
If yes, what is your relationship with the patient?
If you are the patient are you currently on treatment?
If you are the patient, what is your diagnosis?
If you are the patient, what is the date of you diagnosis?
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