Volunteer Volunteer Application Form Name:* First Last Local address:* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code I live at this address:* Year-round Other (describe) Other Preferred telephone number:*This number is a:* Home Cell Work Secondary telephone number (if applicable):This number is a: Home Cell Work Email Address:* DOB:* MM slash DD slash YYYY Gender Description* Pronouns: She, her He, him They, them Other (please describe) Describe: Currently a student:* Yes No IF YES - school attended: IF YES - Field of study (if declared): Currently employed outside the home: Yes No IF YES - Employer’s name: IF YES - Role within company: I learned about JBBBS from (check all that apply):* A past or present JBBBS volunteer (indicate name of past or present volunteer below) A Big Brother/Sister from another agency Another supporter of JBBBS, not a volunteer (indicate name of JBBBS supporter) CJP (indicate name below) Big Brothers Big Sisters of America Another service organization (indicate which organization) My college or university (indicate which college/university) My place of worship (indicate which) Company, Business or Employer (indicate which below) Internet search Other (describe) Describe: I would consider volunteer opportunities with (check all that apply):* Children Children with disabilities/special needs Adults with disabilities I have access to a personal vehicle:* Yes No Please indicate whether you are anticipating any major life changes over the next year (i.e. new jobs, out-of-area moves). If none, write “N/A.”* Please indicate, in a sentence or two, why you’re considering volunteering with us.*
