Volunteer Registration Form

Contact Information

First Name

Middle Name

Last Name

Mobile

Work Phone

Home Phone

Email

Birthdate (Must be 18yrs old to volunteer)

Mailing Street

Mailing City

Mailing State/Province

Mailing Zip/Postal Code

Race/Ethnicity

Gender

Marital Status

Spouse Name (if married)

College(s)

Degree(s)

Past or Current Volunteer Experience

Campus

Time of Day

Days of Week

Volunteer Information

Why do you want to volunteer at Literacy Achieves?

Please list any community affiliations (faith community, sorority, club, league, etc.)

Special skills (areas of expertise, hobbies, etc.)

How did you hear about Literacy Achieves?

Emergency Contact Info

Emergency Contact Name

Relationship

Phone/ Mobile xxx-xxx-xxxx

Reference

Reference Name (Cannot be a relative)

Reference Relationship

Reference Phone Number

Volunteer Reference Email