EmailMe Form - CommunityMinistries Telethon Volunteer Application

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email *

Phone *

### - ### - ####

This is a cell phone. *

Yes

No

If it is a cell phone number, are you able to send/receive text message? *

Yes

No

Do you have up-to-date security clearances? This includes a Pennsylvania State Police Criminal Background Check, a Pennsylvania Child Abuse History Clearance, and if you have not lived in PA continuously for the last 10 years, a FBI Clearance. *

Yes

No

For more information, you can visit www.connmin.org/volunteer Volunteers under the age of 18 do not need clearances.

Check here if you do not have up-to-date security clearances and would like assistance in obtaining the necessary clearances. *

Yes

N/A

Please select N/A if you have already obtained the necessary clearances.

Are you able to lift above 20 pounds? *

Yes

No

How long are you interest in volunteering? The telethon will be from 2:00 pm - 10:00 pm.

All Day

2:00 - 6:00

6:00 - 10:00

Other

Please pick the time frame that works best for you. After you have submitted the form, someone will reach out to your to further discuss the plan for the day.