COUNT ME IN! I'm interested in volunteering with United Way of Pierce County

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Save your progress and complete this form later. (optional)

Please fill in the information below to express interest in one or more of our Signature Programs.

About Me

First Name *

Last Name *

I am volunteering as: *

an individual volunteer

as a company volunteer from as a company volunteer from

Gender: *

Birthdate (Month/Day/Year): * 🛈

Address 1 *

City

State

Postal Code *

Phone *

This phone number is my:

Email Address

Please re-enter your email for verification

Do you have any physical/medical limitations which we need to take into consideration? *

No

Yes, please specify: Yes, please specify:

DEMOGRAPHIC INFORMATION: We are required by our funders to ask for this information, but you are not required to answer it. This information is used exclusively for reporting.

Are you a military service member, retired military, veteran or family member? *

Please indicate the racial/ethnic group with which you identify: *

Language(s) spoken besides English:

Skills, education, training and current/previous occupation(s):

About Volunteering

Why are you interested in volunteering with United Way?

To learn more about any of our volunteer opportunities, please click on the name below:

Hunger

Colorful Cooking Made Easy - cooking demonstrations at food pantries

Cooking Matters Class Leaders - provide families with tools & knowledge to cook healthy meals at home

Cooking Matters Grocery Store Tour Leaders - help families learn to plan meals and shop on a budget

Summer Meal Site Volunteers - prepare and/or serve free lunch to kids in high-need, low-access areas over summer break

Successful Kids

LIL Readers - share stories and activities with preschool age children

READ United: Summer Learning - visit summer meal sites to read with kids and give away books

ALL FOCUS AREAS

Do-It-Yourself Projects - group projects that can be done on your time at your location

Please indicate the program(s) you are interested in volunteering with: *

Please indicate the days/times you are available to volunteer (i.e., Monday mornings, Wednesday evenings and all day Saturdays) *

How did you hear about United Way's volunteer opportunities?

Have you previously volunteered with United Way of Pierce County?

Yes

No

Legal Stuff

VOLUNTEER COMMITMENTS: I understand that I am not an employee of United Way of Pierce Count and agree to serve without compensation. I further agree that if I use my personal automobile to drive to and from my volunteer assignment or during my service, I will maintain a valid driver's license and will keep in effect automobile liability insurance equal to or greater than the minimum required by WA state law. I understand that the information provided on this form may be disclosed for the purposes of volunteerism only. I agree to keep all information about clients, volunteers or other individuals obtained while volunteering confidential. I am under no obligation to accept or continue any assignment unless I choose to do so. I agree to release United Way of Pierce County of any and all claims to myself or others which may arise as a result of any expenses, personal injury, loss or damages incurred during my volunteer participation. I understand that due to the nature of the work performed by United Way volunteers, the program may inquire about any convictions, fines, imprisonment or periods of probation that a prospective applicant has had for violation of any law, police regulation or ordinance. *

By checking this box, I hereby certify that I am over eighteen years of age and am competent to enter into this release. I have read the foregoing release and understand the contents thereof.

COMMUNICATIONS RELEASE: I hereby assign the rights to the video and/or photographic recording(s) made of me participating in volunteer activity by United Way or its agencie(s) and collaborator(s), hereto referred to as United Way, to said United Way. I hereby authorize the editing, duplication, reproduction, copyright, exhibition, broadcast and or nonprofit use and distribution of said recording(s) for purposes deemed suitable by United Way. I hereby waive any right to approve the finished products. I hereby certify that I am over eighteen years of age and am competent to enter into this release. I have read the foregoing release, authorization, and agreement, before affixing my signature below and warrant that I fully understand the contents thereof. *

By checking this box, I confirm that I have read the above release and warrant that I fully understand the statement.

I affirm with my signature below that the information I have provided is accurate to the best of my knowledge. Use your mouse (if using a desktop computer) or your finger (if using a touchscreen tablet? to sign your name. You may click "clear" to erase and start over. *

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