Before completing this application please read the Volunteer Policies, Non-Disclosure Agreement and Code of Conduct Name:* First Last Address:* Street AddressCityState / Province / RegionPostal / Zip CodeE-mail:*Your volunteer confirmation will be sent to you via email. Please enter a VALID email address. Phone:* Area Code - Phone Number Emergency Contact:* First Last Emergency Contact Phone:* Area Code - Phone Number Tell us about yourself and your experience:*Several opportunities require the ability to lift 25-50 lbs., bend, reach and may require extended periods of time on your feet. Accomodations are available.:*Yes, I can lift 20-50 lbs.No, I cannot lift 20-50 lbs.Have you ever been convicted of a crime other than a minor traffic violation?:*YesNoIf yes, charge: Date Convicted: Location: Ordered/Mandatory Community Service by (Agency/Court):: Number of Hours Required: Volunteer Interest:*Food PantryGrocery Rescue OperationsSenior Food Box DeliveryShelterShelter MealsSpecial ProjectsPlease tell us your daily availabilityHours Available Per Week: Monday Start: : AMPMHHMMAM/PMMonday End: : AMPMHHMMAM/PMTuesday Start: : AMPMHHMMAM/PMTuesday End: : AMPMHHMMAM/PMWednesday Start: : AMPMHHMMAM/PMWednesday End: : AMPMHHMMAM/PMThursday Start: : AMPMHHMMAM/PMThursday End: : AMPMHHMMAM/PMFriday Start: : AMPMHHMMAM/PMFriday End: : AMPMHHMMAM/PMSaturday:AMPMSunday:AMPMPlease place your initials in each box certifying you have read and understand the policiesVolunteer Policies:* Non-Disclosure Agreement:* Waiver/Publicity Release:* Code of Conduct:* Signature (Please enter your First and Last Name):*SubmitReset In accordance with Federal law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age, or disability. To file a complaint of discrimination, write USDA, Director, Office of Adjudication, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410 or call toll free (866) 632-9992 FREE (Voice). Individuals who are hearing impaired or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339 FREE; or (800) 845-6136 FREE (Spanish). USDA is an equal opportunity provider and employer. If you would like a copy of your application for your records, please click the printer before you submit your application. You will receive an email confirmation as well.