Your Name (required)

    Your Email (required)

    Street Address

    City, State/Region Zip/Postal Code

    Phone (required)

    Best way to reach (required)

    Are you a Youth Volunteer (17 and under)?(required)

    If Yes How Old Are You

    What is your educational background?

    Do you have any limitations that will restrict your volunteering? (required)

    If yes, please explain:

    Why do you want to volunteer here?

    Do you have any past volunteer experience?

    Please indicate any areas of interest (check all that apply)

    The above information is correct and complete to the best of my knowledge, without consequential omissions. I authorize the organizations and persons named to release any information requested regarding my service, character and qualifications. I understand and authorize the agency to do a background check, and realize my volunteer work is contingent on my police background check. I acknowledge the agency is not obligated to offer me a volunteer position. I further agree to release and hold harmless Variety – The Children’s Charity of the Desert, institutions and references listed above, and any law enforcement agency from all liability and any damage that may result from furnishing this information to you.