Volunteer Form

Join our volunteer team to help make a difference in grieving families lives. Please fill out the volunteer application form below and we will be in contact with you within 24-72 hours.

If you are interested in becoming a volunteer group facilitator - please note that you must be at least one year beyond the loss of a loved one. There are other roles you can play as a volunteer if this metric applies to you.

Volunteer

If you are human, leave this field blank.

Name *

First

Last *

Last

Email *

Address *

Address

City

State/Province

Zip/Postal

Home Phone *

Work Phone

Special Skills or Qualifications *

Summarize special skills and qualifications you have acquired from employment, previous volunteer work, education, or through other activities, including hobbies and sports.

Previous Volunteer Experience *

Summarize your previous volunteer experience.

Emergency Contact Name *

First and Last Name of Person to Notify in Case of Emergency

Emergency Contact Phone *

Phone number of Person to Notify in Case of Emergency

Volunteer Application Type *

Group Facilitator

Special Projects

Thank you for your interest in volunteering as a Group Facilitator with Adam's Place. A tax deductible $50.00 fee is required to cover the cost of a background check and facilitator. Once your application and fee is received you will be notified by email to schedule your training.

$50.00 will be charged to your credit card.

This application is for high school or employer/employee groups that want to volunteer for special events. Volunteers will only be contacted as needed for special projects/events. We appreciate your interest - thank you for your application.

Credit Card

Credit Card Number

Exp month

Exp year

CSV code on rear of card

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. Our Policy – It is the policy of Adam’s Place to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability. Thank you for completing this application and for your interest in volunteering with us.

Signature *

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Volunteer Form

$50.00 will be charged to your credit card.

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