Volunteer Form

Name

Email

Phone Number*

Address

Areas of Interest*

Other areas of interest

Any special talents or skills you have that you feel would benefit our organization.

What days are you available to volunteer?* Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Time Available: Morning
Evening

Any physical limitations you wish to disclose?

Emergency Contact

Name and Number

Volunteer Agreement

As a volunteer of Housing First Umpqua organization I agree to abide by the policies and procedures I will be trained on. I understand that I will be volunteering at my own risk and that the organization, its employees and affiliates, cannot assume any responsibility for any liability for any accident, injury or health problem which may arise from any volunteer work I perform for the organization. I agree that all the work I do is on a volunteer basis and I am not eligible to receive any monetary payment or reward.

Electronic Signature*

Please type your full legal name if you agree to the terms above.