Kaity's Way Volunteer Application
Last Name *
Your answer
Middle Name or Initial
Your answer
First Name *
Your answer
Street Address *
House number and street you live on
Your answer
City
Your answer
State *
Your answer
Zip code *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Best phone number to reach you at *
please include area code
Your answer
Email address *
Your answer
What days of the week are you able to volunteer? *
check all that apply
Required
What time of day are you available to volunteer *
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Required
In what areas would you be interested in volunteering? *
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Required
What area would you prefer to volunteer in? *
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Required
Tell us about your Special Skills and/or Qualifications *
Summarize special skills and qualification you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.
Your answer
Person to Notify in case of an Emergency *
Include their Name, relationship with you and best number to reach them at
Your answer
I agree that Kaity's Way may use any image, photograph, voice or likeness, in its promotional materials and publicity efforts without payment or other consideration. I understand that these photographs, images, video or audio may be retouched or enhanced and may further be used in publications, print ads, electronic media (e.g., video, CD-ROM, Internet/WWW), or other media now known or hereafter created, anywhere in the world. I further understand that by participating in the photography or filming, I release Kaity’s Way and its representatives, employees, board members, licensees, photographers, and their designees from any and all liability for any violation of any privacy or proprietary rights. *
I further agree to the inclusion of my name(s). *
I further agree to being added to the Kaity's Way email distribution list. *
Agreement & Signature By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. *
Enter your name in the required field as your signature
Your answer
For Applicants under the age of 18 parental permission is required
Please provide their Name, Relationship to you and best number to contact them.
Your answer
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