Volunteer Application

Date:

 

Name:
Address:
City: State: Zip Code:  
Email:

Phone Numbers

Home:   Work:   Cell:  

 

Legislative Districts (if known):
State House:
State Senate:

Please tell us why you are interested in volunteering at Planned Parenthood.

Please tell us about your educational experience:

High School/GED:
Some College In:
College Graduate Majoring In:
Post Graduate Degree In:
Technical School Training In:

Training In:

  Arts/Graphic Design
  Bookkeeping/Finance
  Computer/Technology
  Event Coordinator
  Information Systems
  Fundraising/Development
  Health Care
  Human Services/Counseling
  Legal Training
  Marketing
  Media/Public Relations
  Public Speaking
  Training & Development
  Writing
  Other:
      If other please list:

Please check all of the volunteer activities that interest you.

  Advocacy/ Public Affairs
  Desktop Publishing
  Fundraising/Development
  Special Event Planning and/or Staffing
  Sexuality Education
  Filing/Clerical
  Reception Desk
  Research (Medical)
  Research (Prospect)
  Typing/Data Entry
  Writing (newsletter, press releases, etc)
  Public Speaking
  Other:
      If other please list:

Please rank your top three preferences, #1, #2, and #3.

Top #1:
Top #2:
Top #3:

 

We reserve the right to obtain the criminal background record of applicants. Please check here indicating you are aware of this policy and that you grant us permission to do so.

 

Approximately how many hours can be available to volunteer:

Hours Per Week
Hours Per Month
Varies/Unknown

Which are the best times for you to volunteer?

Which of our locations is best for you?
  Carlisle
  Harrisburg
  Lancaster
  Lock Haven
  State College

Please indicate your current, or most recent, employer and/or any other
organizations for which you currently, or most recently, have volunteered.

Please list any civic, social, fraternal, sororal, or professional organizations to which you belong.

References:

Name
Address
Phone Number(s)

 

Name
Address
Phone Number(s)

If you are under the age of 18, you must have your parent or legal guardian
check this application here:

If you have any questions, please call 717-234-2479 ext. 110.
Thank you for your interest!