Triumph Foundation

Volunteer Registration


First Name:  

Last Name:  

DOB:  

Email:  

Phone:  

Address:  

Are you a person with a disability?:  

If Yes:

-- Disability Type:  
-- Description:  
-- Date of injury/diagnosis:  
-- Cause of injury:  

If No: 

-- Does your family member (or loved one) have a disability?:  
-- Tell us more:  

 

Gender:  

Do you speak any additional languages?:  

-- Languages:  

Emergency contact name:  

Emergency contact number:  

Are you volunteering for a class or project?:  

If Yes:

-- School:  
-- Area of study:  
-- Professor's name:  
-- Number of hours needed:  

 

Do you have any restrictions on lifting (25-50 lbs)?:  

Do you feel comfortable lifting (50+ lbs) ex: Transferring?:  

Do you have any special accommodation requests?:  

Accommodation Request:  

Do you have any criminal history?:  

If Yes: 

-- Provide a full explanation of the conviction or pending charges. (A conviction or pending charge will not necessarily disqualify you from volunteering.  Each situation will be considered on its own merits.):  

 

How did you hear about us?:  

Are you under the age of 18?:  

 

If APPLICANT IS UNDER THE AGE OF 18, A PARENT OR GUARDIAN SIGNATURE IS REQUIRED.

PARENT OR GUARDIAN PLEASE SIGN THIS FORM.

Parent/Guardian Name:   

Relationship:  

I agree to be on-site and provide supervision during the volunteer service:  

Leave this empty:

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Signed by Andrew Skinner
Signed On: May 18, 2020

Triumph Foundation https://triumph-foundation.org
Signature Certificate
Document name: Volunteer Registration
lock iconUnique Document ID: fca632962e2c458eff7947fe12e07065a91b0c95
Timestamp Audit
May 18, 2020 2:14 pm PSTVolunteer Registration Uploaded by Andrew Skinner - [email protected] IP 45.49.123.176