Volunteer Application Form
Please complete this application form if you are interested in becoming a Ability Connection volunteer. Once you complete the form, click the Continue button at the bottom.
If you have any questions, please reach out the the Volunteer and Community Outreach Manager directly at lcole@abilityconnection.org
Contact and General Information
First name:
*
Last name:
*
Middle name:
Street 1:
*
Street 2:
Street 3:
City:
*
State:
Choose
TX
*
Zip:
*
Home phone:
OK to call me here
Cell phone:
*
Email address:
*
Date of birth:
Month
Jan
Feb
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Dec
Day
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Year
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1918
*
Age:
Gender:
Choose
Female
Male
T-Shirt size:
Choose
Extra extra Large
Extra Large
Large
Medium
Small
Emergency Contact Information
You may optionally provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.
1
2
First name:
*
First name:
*
Last name:
*
Last name:
*
Home phone:
Home phone:
Cell phone:
*
Cell phone:
*
Relationship:
Choose
Co-worker
Daughter
Father
Friend
Mother
Neighbor
Son
Spouse
Supervisor
*
Relationship:
Choose
Co-worker
Daughter
Father
Friend
Mother
Neighbor
Son
Spouse
Supervisor
*
Personal and Professional References
1
2
First name:
*
First name:
*
Last name:
*
Last name:
*
Work phone:
Work phone:
Cell phone:
*
Cell phone:
*
Email address:
*
Email address:
*
Relationship:
Choose
Co-worker
Daughter
Father
Friend
Mother
Neighbor
Son
Spouse
Supervisor
*
Relationship:
Choose
Co-worker
Daughter
Father
Friend
Mother
Neighbor
Son
Spouse
Supervisor
*
Time Commitment and Availability
Please indicate the days and times you are usually available to volunteer.
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Morning:
Afternoon:
Evening:
My availability is:
Choose
Ongoing
Ongoing, except between these dates
Only between these dates
From:
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
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5
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29
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31
Year
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
to:
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
3
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5
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31
Year
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
I would like to serve up to:
hours:
Choose
Daily
Monthly
One time
Weekly
Additional Questions
Please let us know if you have any questions.
Volunteer Agreement
By checking 'I agree'
I certify that my answers are true and complete to the best of my knowledge.
I authorize investigation of all matters contained in this application or data pertinent to my volunteering.
I acknowledge that any false statements or misrepresentation on this application will be cause for refusal of placement or immediate dismissal.
I understand and agree that in the performance of voluntary services I am not an Ability Connection employee and shall have no rights to wages or benefits and no promise, expressed or implied, of consideration for future employment.
I agree to indemnify and hold Ability Connection, its employees and contractors, harmless from any and all liability for any injury that may be suffered arising out of or in any way connected with my participation in this program.
I also agree to grant full permission to Ability Connection to use my name an any photographs, videography, motion pictures, or recordings for any purpose whatsoever without any obligation, liability, or compensation to me.
I Agree
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