Please complete this application form if you are interested in becoming an Easterseals Washington volunteer.

When completed, please send an email indicating how you heard of us and what your specific volunteer interests are to

Personal Information

Demographic Information

This information is used only to help us get a better idea of the demographic make-up of our volunteers.


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

Volunteer Interests, Skills and Certifications

Please mark all that apply

Will you be providing a skilled volunteer service?

If you are a professional and wish to volunteer utilizing the skills you normally are paid to do, please indicate the VALUE of your skill (hourly wage/flat billed rate)

Location(s) are you interested in volunteering at?

Education and Training


Employment Experiences

Enter your current or last job. If you do not have any employment experiences enter "Not Applicable" or "N/A" in the field.

References - -Required if not a remote volunteer

Please provide 2 personal or professional references. DO NOT LIST IMMEDIATE FAMILY.

Emergency Contact Information

In case of an emergency, person listed below will be contacted.


I hereby certify that I have personally completed this application and that the answers given by me to the foregoing questions and statements are true and complete and that no material fact has been omitted. I understand that any false statements appearing on this or any other volunteer form will be sufficient reason to end further consideration of this application; if discovered after my volunteer services begins, such false statement will be sufficient reason for dismissal from the services of Easterseals Washington (ESW) regardless of the time that has elapsed before discovery.

I authorize ESW or its designated agents to contact my references and to investigate my past employment, education credentials, Department of Motor Vehicles driving record, and other volunteer-related activities, without giving me prior notice of such disclosure. I agree to cooperate in such investigations and release those parties supplying such information to ESW from all liability or responsibility with regard to the information supplied.

I understand that submitting this application in no way assures me a volunteer position with ESW, and that this application is not, and is not intended to be, a contract. I understand that the terms of my volunteer commitment are contingent upon approval of the Director or VP of HR, and or the CEO of ESW, and on successful completion of a criminal background check. I understand that if accepted, my volunteer opportunity can be terminated, with or without cause, and with or without notice, at any time and at the option of ESW.

If accepted as a volunteer by ESW, I agree to abide by the rules, policies and procedures of ESW and subsequent rules, policies and procedures that may become effective after acceptance. I understand that ESW believes strongly in a drug-free work environment and agree to abide by the drug and alcohol policies of ESW during the time of my volunteerism. I further understand that ESW abides by all Washington State laws pertaining to smoking restrictions and maintains a smoke-free work place and I agree to abide by those laws and practices.