Volunteer Application
Thank you for your interest in volunteering with Alianza DV Services, Inc. Please complete and submit this form. (You may also print and mail this form to Alianza - Development Office, P.O. Box 1099, Holyoke, MA 01040.)

Please be advised that volunteering with Alianza will require you to have your own transportation and may require a CORI check.

Once your application is reviewed you will be matched with a volunteer job or task.  A staff member will contact you to set up an interview. All information on this form will be kept confidential and will help us find the perfect volunteer role for you.  

About Alianza:  We are a nonprofit organization working in Western Massachusetts to provide assistance, support, and empowerment for those who are affected by domestic and intimate partner abuse. We provide 24hr/day-7 day/week emergency Hotline, safety planning, emergency shelter, housing and medical advocacy, and assistance with court-based issues related to domestic violence. Our services are survivor-centered and provide the emotional support, empathy, and the space for survivors of domestic violence to tell their story.

Email *
Name *
Preferred pronouns *
Street *
City, State, Zip Code *
Home Phone
Cell Phone *
Email *
Employer (if applicable) *
Age Range *
Do you have any special skills you would like us to consider when placing you in a position? *
Please list any languages you speak fluently *
Current volunteer opportunities are below. Please check which jobs are of interest. *
Which days are you available? *
Please list any accommodations that you may need: *
Liability Release
As a volunteer of Alianza I agree to abide by all policies and procedures as spelled out in the volunteer handbook. I understand that I volunteer at my own risk and neither the organization nor its employees assume any liability for any accidental injury or health problem arising from volunteer work I perform for the organization. I agree that all work I do is on a volunteer basis and I am not eligible to receive any monetary payment or reward.
The name and photo associated with your Google account will be recorded when you upload files and submit this form
Signature *
Clear form
Never submit passwords through Google Forms.
This form was created inside of Alianzadv. Report Abuse