Volunteer Form
All Volunteers, SYEP Workers, Interns, Community Service Workers etc...
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Upcoming Opportunities
*
Update Me on All Opportunities
Shop With A Hero (December 2026)
Tuesday Food Pantry Support (Heavy Lift)
3rd Wednesday Monthly Grocery Distribution
Re-Employability
55+ Program
School Service Hours
Summer Youth Employment Program
Other
Languages Spoken
*
English
Spanish
ASL
Other
Are you a U.S. Military Veteran
*
No
Yes, I'm Active Military
Yes, I'm A Veteran
Are you volunteering with an organization?
*
Yes
No
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Emergency Contact Name
Emergency Contact Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
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Organization Information
(Optional but preferred)
Organization
Email
example@example.com
Business Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Website
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Household Information
This Information provided through this form is used to assist UCC in expanding the services we provide by identifying the demographics of the clients & volunteers we serve.
# of Children (Ages 0 - 18)
*
Please Select
None
1
2
3
4
5
6
7
8
9
10
# of Adults (Ages 18 - 62)
*
Please Select
None
1
2
3
4
5
# of Seniors (Over age 62)
*
Please Select
None
1
2
3
4
Race/Ethnicity
*
African American
Hispanic / Latino
Caucasian
Asian
Prefer Not To Say
Other
Gender
*
Male
Female
Other
Signature
*
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