VolunteerPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 6Personal InformationName *FirstLastPreferred Name (if different)FirstLastPronouns *--- Select Choice ---He/HimShe/HerThey/ThemHe/TheyShe/TheyPrefer Not to SayNextContact InformationAddress *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Phone *PreviousNextVerification Details (Kept Confidential)Birthdate *Social Security Number – Required for Background CheckTo protect your privacy, we do not collect your Social Security Number through this form.Please check the box below to acknowledge that:You understand your SSN is required for background screeningYou will provide it by phone or in personYou agree to bring it securely with you, or call us to share it confidentiallyPlease acknowledge the following: *I acknowledge and agree to the above.How would you like to provide your SSN? *I will call to provide it by phoneI will bring it with me in person(Please select one)How to Provide Your SSN by PhoneThank you! After submitting this form, please call us at (385) 474-2083 to securely provide your Social Security Number.For your convenience:You can save our number in your phoneOr write it down now so you're ready to call after submittingWe’re available to take your call during business hours. Thank you for helping us keep your information secure!How to Provide Your SSN In PersonThank you! Please don’t forget to bring your Social Security Number with you when you come in.Be sure it’s stored or written down securely before you arrive.We’ll collect it safely and privately during your visit. We appreciate your cooperation!PreviousNextEmergency Contact Information Method Do Phone Name *FirstLastRelationship to You *--- Select Choice ---ParentSpouse / PartnerSiblingChildFriendRoommateNeighborEmployer / SupervisorCo-workerEmergency Contact ServiceOtherPlease Specify *Required if you selected "Other." Please describe the relationship.Phone *Preferred Phone Contact Method *--- Select Choice ---CallTextCall or TextEmail *Alternate Phone Number (optional)Preferred Alternate Phone Contact Method--- Select Choice ---CallTextCall or TextPreviousNextVolunteer Roles & AvailabilityWhat are you interested in volunteering for? *Volunteer Victim AdvocateOffice VolunteerEvent VolunteerVolunteer InterpretingConsider your strengths and interest. You may check one or more.Times of availability *Weekday morningsWeekday afternoonsWeekday eveningsWeekendsAlso for on call as emergency advocacy serviceOtherIt would help us to know times of the you're available.Please specify *Required if you selected "Other." Please describe the times of availability.PreviousNextGetting to Know YouPrevious Volunteer ExperienceMaximum 500 characters.Why Do You Want to Volunteer for Sego Lily? *Maximum 500 characters.PreviousSubmit
