Adult Volunteer Application

Full Name*

First Name Last Name

Birth Date*

Month Day Year

Address*

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

Home Phone*

Area Code Phone Number

Cell Phone*

Area Code Phone Number

E-mail*

Occupation*

Gender*

Male Female

Please list hobbies, talents or special interests (music, art, drama, martial arts, etc)

Program Marketing/Outreach

Yes No

Event Photography

Yes No

Office Assistance

Yes No

Event Phone Calls

Yes No

Fundraising

Yes No

Other

SUNDAY CIRCLE:

Join us for 2 hours of fun and entertainment with a young child with special needs. At each Sunday Circle, you will join your buddy in an art class, play time and music. NOTE: Punctuality and commitment are very important!

YOUNG ADULT CIRCLE:

Join us for 2 hours of fun at Young Adult Circle, where you and your buddy will learn life skills useful for an everyday basis! Our program includes everyday activities, social skills, cooking, shopping, adventures and entertainment, which simultaneously incorporate independence, laughter, and friendship that make for great memories.

SUMMER/WINTER CAMP:

Join us for an experience that will last a lifetime! At the FC Winter/Summer Camps you will transform your vacation as well as the vacation of a child with special needs into an exciting camp experience with fun-filled activities, games, sports and field trips. Commitment: 5.5 hrs. each day for one week per camp.

BASKETBALL BUDDIES:

Basketball buddies is a way that the volunteers and kids can be with each other while playing a sport they love. This program allows for the kids to be part of a team, and to learn the fundamentals of Basketball.

SOCCER STARS:

Soccer Stars pairs volunteer soccer players with kids, teens, and adults to teach them the fundamentals of soccer. They get to be part of a team and they play a scrimmage game each session. No prior experience is necessary to participate.

HANGIN' WITH FRIENDS:

This program is for adults with special needs and volunteers 15+. This program will offer entertainment and fun activities that are more age appropriate for our young adults and provide them with even more opportunities to make new memories with their friends.

FRIENDS @ HOME

Volunteers get together with their special needs buddy in the child's home for 1 hr. every week or at least twice a month. This program provides the opportunity for teens to get to know their friend with special needs on a more personal level and build a relationship that last forever!

Full Name

First Name Last Name

Relationship

Phone

Area Code Phone Number

Full Name

First Name Last Name

Relation

Phone Number

Area Code Phone Number

In case of medical emergency requiring immediate emergency care, I authorize the paramedics to take me to the nearest hospital if necessary

Yes No

Health Insurance Name

Number

Allergies

Medical Concerns

*

In the event that I am unable to volunteer I will try to find another day to substitute and I will call my special friend in advance

*

I will send in a report after every time I volunteer

*

In the event of a volunteer function I will try my hardest to attend however, regardless, I will always respond.

Adult Volunteer Information

Volunteer Interest

What programs interest you?

Professional Reference

Medical Information

Volunteer Agreement