TROT - Volunteer Application Form

Please complete this application form if you are interested in becoming a Therapeutic Riding of Tuscaloosa volunteer. Once you complete the form, click the Continue button at the bottom.

Contact Information

Thank you for expressing interest in being a Volunteer Mentor at Therapeutic Riding of Tuscaloosa. We ask that you make a commitment to a specific day and time each week to work with the TROT program, and make a commitment to serve for at least 8 weeks. TROT is a volunteer driven program. Without our volunteer mentors we would not be able to operate, so the clients we serve depend on you.

First name:

Last name:

Title:

Street 1:

Street 2:

Street 3:

City:

State:

Zip: *

Home phone:

* OK to call me here

Work phone:

OK to call me here

Social Security Number:

DL Num, State, Exp:

Immun UTD, can provide:

Demographics

Date of birth:

Gender:

Education:

T-Shirt size:

Major degree:

High school:

College:

Emergency Contact

In the event of an emergency whom should we notify? Please list name, relationship to you, home and cell phone numbers.

First name:

Last name:

Title:

Street 1:

Street 2:

Street 3:

City:

State:

Zip:

Home phone:

Work phone:

Email address:

Relationship:

Criminal Offense

Convicted of any criminal offense. date and resolution:

Employment

Employer name:

First name:

Last name:

Title:

Street 1:

City:

State:

Zip:

Work phone:

OK to call here

Cell phone:

OK to call here

Email address:

Skills & Experience

Availability

Please indicate the specific days and times you are available to volunteer.

Sun

Mon

Tue

Wed

Thu

Fri

Sat

From:

To:

Personal References

1

2

First name:

Last name:

Work phone:

OK to call here

Work phone:

OK to call here

Email address:

Contacted:

Verified:

previous volunteer experience

Please list other places you have served as a volunteer.

EMail

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.

Volunteer Information Center

We provide an online "Volunteer Information Center" where volunteers may check their schedules, update their information, and receive messages. Please select the password you would like to use to access the online Volunteer Information Center.

Please enter a password that:

Is between 8 and 30 characters long
Contains both letters and numbers.
Contains a combination of both uppercase and lower case letters.

Password:

Confirm password:

non discrimination policy

We do not discriminate on the basis of race, creed, color, gender, sexual or religious preference. We believe that the world is made of many different people, each with their own unique gifts, and that appreciation of those gifts is the basis for peaceful co-existence.
Your application will be reviewed, and a brief background check run. This is necessary due to the population you will be serving. If approved, you will need to successfully complete a training course before actually being given a volunteer assignment.

I Agree

I understand and agree that submitting this application form does not automatically register me as a Therapeutic Riding of Tuscaloosa volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering.

By submitting this form, I attest that the information I have provided on the form is true and accurate.

I Agree