Poe Center Volunteer Application
Thank you for your interest in volunteering at the Poe Center!  We value your contribution of time and resources.  Your first step to becoming a Poe Center Volunteer is to complete the application information below. For questions about volunteering at Poe, please contact Samantha Tripp at s.tripp@poehealth.org.
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Email *
First Name *
Last Name *
Birth Month *
Birth Date *
Birth Year
Street Address *
ex. 224 Sunnybrook Road
Street Address Continued
Apartment or Suite Number, etc.
City *
ex. Raleigh
Zip Code *
Phone Number *
Please include area code
Other Contact Phone Number
Please include area code
Email Address *
Referring School or Organization, if applicable
Please include the address of the school or organization.
Grade Level *
Referring Instructor Contact Name
Referring Instructor Contact Information
Best email or phone number for reaching your referring instructor.
Emergency Contact Name *
Emergency Contact Phone *
This MUST be a phone number where your emergency contact can be reached.
Please list any medical conditions or allergies we need to be aware of (ex: having an epi pen for bee stings) 
Volunteer Experience *
Please describe in 250 words or less your previous volunteer experience(s).
Days and Times and Duration of Availability *
Please describe the days and times you are available to volunteer as well as the length of your volunteer time.
Other Community Activities/Ongoing Responsibilities *
Include any jobs/volunteering along with your hourly commitment to each.
Why do you want to be a Poe Center Volunteer? *
Describe what about Poe motivates you to want to be on our team?
Please describe what you can bring to the Poe Center. *
List talents, skills or interests you have that would benefit Poe.
Goals *
Please describe three (3) goals that you hope to achieve by the conclusion of your volunteer experience at Poe.
Orientation Availability *
Please identify time of day that you are available for a volunteer orientation.
Required
Please select your areas of volunteer interest.  See the volunteer webpage for position descriptions. *
Please check all that apply.
Required
Program or Course or other Mandatory Requirement? *
Please indicate whether your volunteerism is required for program, course, or otherwise mandatory.
If you are 18 years of age or older, do you give the Poe Center permission to complete a background check? *
If you are under 18, please select "Not Applicable."
Would you like to receive email updates and e-newsletters from the Poe Center? *
Help us stay healthy!
In order to keep all healthy and safe, if you are not feeling well please do not come in for your shift. Instead, please let your staff contact know and/or call Poe at 919 231 4006 to inform the front desk.
A copy of your responses will be emailed to the address you provided.
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