Youth Volunteer Registration Form If you have any questions please contact:Harriet KlatteVolunteer Coordinator412-408-3830 x 3204hzklatte@nhco.org Name * First Name Last Name Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Please send me NHCO’s monthly e-newsletter with volunteer opportunities. * Yes No NHCO may use my name and/or photo in publications, press releases or other publicity materials. * Yes No How did you learn about North Hills Community Outreach? * In case of emergency, please contact: * Emergency contact's relationship * Emergency contact's Phone * (###) ### #### In case of emergency, please contact: * Emergency contact's relationship * Emergency contact's Phone * (###) ### #### School and Grade * Please list community, congregations or other organizations to which you belong: * Do you have a volunteer service requirement? * Yes No If yes, please tell us who is requiring you, how many hours you need, and when they need to be completed. Demographics (Optional – used for grant applications) Date of birth * MM DD YYYY What gender do you identify as? (Optional) Race/Ethnicity (Optional) African-American Hispanic Caucasian Asian-American Other Special skills, interests, or hobbies you’d like to share: Current or previous volunteer activities: Please check all of the following activities that interest you. * Collections (food, coats, toys, etc... Community Organic Garden Yard work for seniors Snow shoveling for seniors Special events/fundraisers Salvation Army Kettles (Bell Ringing) NHCO office grounds work Other Activities that you would prefer not to do: Physical/medical limitations of which we should be aware (steps, lifting, standing, etc.): I'm available (please check all that apply) Summer vacation Holidays After School Weekends Consent (If the volunteer is under the age of 18, a parent/legal guardian must complete this section.) * I give my consent for this applicant to volunteer at North Hills Community Outreach. I give my consent for this applicant’s name and/or photograph to be used in North Hills Community Outreach’s publications, press releases or other publicity materials. Confidentiality * When volunteering, we ask the volunteers to put themselves in the clients’ shoes, and keep the identities of the families using NHCO services confidential. If taking photos or selfies while volunteering for NHCO, do not take photos that include clients, or post photos on social media that include clients. Will you comply with this? Yes No Thank you for your interest in volunteering with North Hills Community Outreach. Somebody will get back to you shortly.
