Volunteer Disaster Registration

NOTE: THIS APPLICATION IS RESERVED FOR COMPLETION IN THE INTEREST OF DISASTER RESPONSE/RECOVERY EFFORTS.

THANK YOU for your interest in assisting with disaster response/recovery. Complete the information below to assist us with matching you to an assignment that aligns with your skills and interests as they become available.

Basic Information

First name:

Last name:

Middle name:

Title:

Nickname:

Age Category:

Date of birth:

Gender:

Education:

Shirt Size:

Ethnicity:

Aliases:

FL Drivers License or ID:

Contact Information

Message Preferences: 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.

Street:

Apt/Ste/Unit/Lot:

City:

State (US) / Country:

* Zip/Post Code: *

Home phone:

Cell phone:

Other phone:

Email address:

What kinds of email would you like to receive?

Opportunity Announcements

Opportunity Announcement emails are sent when a new opportunity is available and is either a one day project/event or is in immediate need of help.

Volunteer Recognition Event

Volunteer Recognition Event emails are sent in regards to ONLY the annual recognition event hosted by Volunteer Polk.

Program Updates

Program Update emails are sent when new features are available to you for access to your volunteer information, when new policies apply to the way volunteerism works in the county, or other important news about Volunteer Polk.

Emergency Contact

In case of emergency who is your primary emergency contact?

1

2

First name:

Last name:

Nickname:

Home phone:

Cell phone:

Other phone:

Email address:

Relationship:

3

4

First name:

Last name:

Nickname:

Home phone:

Cell phone:

Other phone:

Email address:

Relationship:

Group Volunteer Registration

If you are part of a non-disaster response group that wishes to volunteer (i.e. Haines City Rotary Club, The employees of ABC Retail, etc.), please include your group name and city/state.

Group name:

Members:

Participation:

If your group will serve more than once, you will usually send...
The same volunteers each time
Different volunteers each time

Skills and Experience

Skills checked here will help us to match you to an assignment based on need.

How did you hear about us?

How did you find this application?

Recruitment:

Availability and Location

Please indicate the days and times you are usually available to volunteer and where you would be able to help.

RSVP Enrolled Volunteers ONLY

If you are age 55 or older, are you currently enrolled in RSVP Polk? (Michelle Shiver)

RSVP Enrolled:

Volunteer Portal

Volunteer Polk provides a volunteer portal for you to view and edit your information online as well as see the service you provided once it has been electronically entered. You will also be able to export your service records.

Please enter a password that:

Is between 6 and 30 characters long

Password:

Confirm password:

Volunteer Polk Page | Privacy Policy