Stomach Cancer Relief Network Inc. Online Volunteer Application Form

Scheduling & Availability
Please indicate the days and times you are usually available to volunteer.

  Sun Mon Tue Wed Thu Fri Sat  

My availability is:
I would like to serve up to:
Please tell us anything additional we may need to know about your scheduling and availability.

Personal Information
Please make sure to fill out this section as thoroughly as possible. This will help us keep you informed of volunteer opportunities!

First name:  *
Last name:  *
Street 1:  *
Street 2:
Street 3:
City:  *
State:  *  Zip:   *
Cell phone:
Email address:  *
Date of birth: (year optional)
Gender:  *

Please provide two references of which one is not related to you.

 1  2
First name: First name:
Last name: Last name:
Title: Title:
Cell phone: Cell phone:
Relationship: Relationship:

Please enter your most current educational status or in progress.

Agreement Section
I certify, to the best of my knowledge, that all information given by me/applicant in this application and in any other forms I/applicant complete during the application process is true and correct. I understand that false or misleading statements made by me/applicant or consequential omissions of any kind in the application process, are sufficient cause for not being accepted as a volunteer or for being dismissed if I/applicant am already a volunteer no matter when discovered.

I understand that there will be an interview prior to my/applicant being accepted as a Stomach Cancer Relief Network Inc. volunteer and I/applicant have read, understand, and accept the Volunteer Agreement terms. I understand that youth volunteers must be at least 16 years of age with parental consent to be accepted.