Night to Shine Volunteer Registration (Ages 18 & older)

Information

Name *

Name

First Name

Last Name

Age/DOB *

Gender *

Gender

Female

Male

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

Phone

(###)

###

####

Background checks are required for ALL volunteers over the age of 18.

Former Special Needs Skills/Training (please check all that apply):

Fluent in American Sign Language (ASL)

Special Education Teacher

Healthcare Professional

if so, please list field *

Current Volunteer in a special needs ministry

Other

Please explain:

I have volunteered at Night to Shine Before: *

Yes

Volunteer Role Requested (we will contact you about your request): *

Additional Notes or Concerns: *

For office use only:

Background check Completed

YYYY

Volunteer media release form

date received

YYYY

Copy of SS and driver’s license

date received

YYYY