Volunteer Thank You! Personal Info:First Name *Last Name *Email Address *Phone Number *No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. All the above categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties. *I acceptStreet Address *City *State/Province *ZIP / Postal Code *Date of Birth *Race/Ethnicity (Grant Purposes Only)Religious AffiliationCriminal History *Select OneYesNoIf yes, please explain the charge including month/year of convictionInterested Position *Select OneMentorBoutique VolunteerDonation ProcessorAvailability: Check all that applyMonday - 10am-12:30pmMonday - 12:30pm-3pmTuesday - 10am-12:30pmTuesday - 12:30pm-3pmWednesday - 10am-12:30pmWednesday - 12:30pm-3pmThursday - 10am-12:30pmThursday - 12:30pm-3pmFriday - 10am-12:30pmFriday - 12:30pm-3pmExperience & Motivation:List your previous volunteer experience (if any)Why do you want to volunteer with us? *What impact do you hope to make? *How did you hear about us?Emergency Contact InfoEmergency Contact *Phone Number *Email Address *How many hours a week? *Signature *Start signing your signature hereYour browser does not support e-Signature field.Date SignedIf accepted as a Grace Place volunteer, my signature below indicates that I understand and agree to the following terms: All information on this applications is true and complete. I understand that any falsification, omissions, or misleading information will be considered just cause fdor immediate dismissal. I also understand that there may be no positions available but will be notified when a position opens up.By providing my phone number to Grace Place Pregnancy Care Center, I agree and acknowledge that Grace Place Pregnancy Care Center may send text messages to my wireless phone number for any purpose. Message and data rates may apply. Message frequency will vary, and you will be able to Opt-out by replying “STOP”. * VolunteerPlease do not fill in this field.
