Volunteer Application Fall 2021
Please fill out this form, to volunteer with the Native Health Initiative, a partnership to address health inequities through loving service. NHI is a 501(c)(3) organization whose services focus on 4 areas: youth capacity building, cultural exchange, community-led projects, and Indigenizing wellness.

We invite volunteers youth- adults, any age, sexual orientation, race or creed to serve with NHI!

Application deadline: Fri, 9/10

All information on this form will be kept confidential and will help us find the perfect volunteer opportunity for you. Please be advised that, since we work with all populations, ages, and abilities, we may require a background check. We will advise how this may be done in the most efficient way.

We look forward to serving with you!
Which of the 3 positions for this Fall are you applying for?
Clear selection
If applying for NHI Staff, do you feel you would be able to serve with NHI this fall as well (Aug-Dec 2021)??
Clear selection
Name (First, Middle Initial, and Last) *
Parent/Guardian Name (First/Last), if you are a minor:
Mailing Address *
Email *
Phone number *
Date of Birth (mm/dd/yyyy): *
Age: *
Ethnicity/Race/Tribal Affiliations:
Pronoun (he, she, them, etc): *
Current education level *
Explain "Other" from previous question -
Why do you want to serve with the Native Health Initiative? *
What skills, special interests, or experiences do you have that you would like us to consider when placing you into a volunteer position?
Here are some of the volunteer programs you may be working with in NHI. Please check the ones you would be most interested in: *
Required
What days are you available this summer? *
Required
How many hours are you available each day, and list times? *
Please describe any health issues that may affect your work with NHI (allergies, etc.)? *
Best Emergency Contact (Name, Phone, Relationship): *
Consent to Volunteer- Full Name, Email, and Phone Number. FOR Minor Volunteers provide parents Parent/Guardians Full Name, Email, and Phone Number. *
Please provide the names and contact information of two references (Name, Phone, and their relationship to you):
Liability Release: As a volunteer of the Native Health Initiative, I agree to abide by all policies and procedures as informed by the NHI organization. I understand that I volunteer at my own risk, and neither the organization nor its program affiliates, health partners, sponsors, or associated leaders to 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. **PLEASE SIGN and DATE (type name/date to confirm signature) *
Date of Signature: *
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