Volunteer Registration Form

Contact Information

First Name

Middle Name

Last Name

Mobile

Home Phone

Work Phone

Birthdate (Must be 18yrs old to volunteer)

Race/Ethnicity

Gender

How did you hear about Literacy Achieves?

Email

Mailing Street

Mailing City

Mailing State/Province

Mailing Zip/Postal Code

Volunteer Information

Marital Status

Spouse Name (if married)

Why do you want to volunteer at Literacy Achieves?

Volunteer Availability and Skills

Campus

Time of Day

Days of Week

College(s)

Degree(s)

Past or Current Volunteer Experience

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

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

Emergency Contact Info

Emergency Contact Name

Relationship

Phone/ Mobile xxx-xxx-xxxx

Reference Contact Info

Reference Name (Cannot be a relative)

Reference Relationship

Reference Phone Number

Volunteer Reference Email