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 as well as a link 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 *
Your answer
Middle Name
Your answer
Last Name *
Your answer
Name you would like to be called, if different...
Your answer
Gender *
Date of Birth *
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Are you over the age of 18? *
T-Shirt Size *
Drivers License #
Your answer
Permanent Address Line 1: *
Your answer
Permanent Address Line 2: *
Your answer
How long have you lived at this address? *
Your answer
If less than 5 years, please provide previous address:
Your answer
Email Address: *
Your answer
Phone Number: *
Your answer
Place of Employment: *
Your answer
Position: *
Your answer
Supervisor: *
Your answer
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.
Your answer
Personal Reference Contact: *
Address, E-mail or Phone Number
Your answer
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...
Your answer
What type of volunteer opportunities are you currently interested in at BASE Camp? *
Required
Are you a patient/sibling/child of a family member with a Hematological/Oncology Illness? *
If yes, what is your relationship with the patient?
Your answer
If you are the patient are you currently on treatment?
If you are the patient, what is your diagnosis?
Your answer
If you are the patient, what is the date of you diagnosis?
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