If you are interested in joining YouthCorps please fill out the application below. You will be contacted soon by a Youth Services representative. Thank you for your interest in our program. We look forward to meeting you!
Volunteer Information
First Name:
Last Name:
MI:
Street Address:
Street Address2:
City:
State:
Zip:
Home Phone: (no dashes or dots)
Work Phone: (no dashes or dots)
E-mail: (for confirmation)
Birth Date: (format:01/01/1987)
YouthCorps Information
Current Red Cross Volunteer?:
yes no
If yes, where/dates?
Do you have any physical or mental conditions, which might affect your ability to perform the type of volunteer services, which interest you?
yes no
If yes, please explain and list any accommodations, which might help.
Gender:
Ethnicity:
Emergency Contacts
Emergency Contact 1 Name:
Street Address:
Phone: (no dashes or dots)
Relationship:
 
Emergency Contact 2 Name:
Street Address:
Phone: (no dashes or dots)
Relationship:
School Information
School Attending:
Grade:
Address:
Phone: (no dashes or dots)
Guidance Counselor's Name:
Additional Comments:
I understand that this is an application for a volunteer position and not a contract of employment. I further agree that as a Red Cross Volunteer, I may not accept payment for my services, and that I will incur the cost of uniforms and transportation. I understand that as a volunteer I am required to abide by all rules and regulatins of the organization. I will also take required training where applicable. I further release all parties from liabilty for any damage that may result from furnishing information to you. As a condition of considering this registration, I will sign the neccessary documents and authorize the release of any information maintained by local, state or federal agencies. In addition, I authorize any verification of applicable licensure if it is required for my volunteer position. The statements made on this registration form are true, complete and correct. I understand that any misrepresentation, omission of information, or misleading and incomplete data shall result in possible disqualification form consideration or dismissal as a volunteer. The Red Cross retains the right of refusal of acceptance, and this application does not ensure that volunteer placement will be made.
Please read the authorization form above and verify your understanding. yes no