VITA Volunteer Application

What's your email address?

Your information


Required fields are marked with an asterisk (*). One of the fields below is a file upload/attachment, the file size must be less than 10MB.
Title
First Name *
Preferred Name (nickname)
Last Name *
Address *
City *
State *
Zip Code *
Mobile Phone *

For example, 123-456-7890
SMS/text messaging: By providing your mobile number and checking the box below, United Way of Summit and Medina County will be allowed to send you SMS (text) messages relating to their volunteer activities. To opt-out, reply STOP to any SMS message OR return to this form and uncheck the box.
Would you like to sign up for the general UWSM newsletter?
Occupation
Employer or School (if student)
Have you ever volunteered at a VITA site before? *
If yes, how many years have you volunteered?
Do you plan to volunteer at any other VITA/TCE or AARP sites in addition to United Way of Summit & Medina? If yes, please list the other site names.
Please list any accommodations you require.
Please list any language(s) you are fluent in (besides English)
Are you volunteering to receive continuing education credits? *
Why do you want to be a VITA volunteer? *
How many shifts are you willing to commit to? *
Which VITA site(s) would you like to volunteer at? (select all that apply) *


Which shifts are you available? (select all that apply) *







Which volunteer position(s) are you interested in? (select all that apply) *





How did you hear about this opportunity? *
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