Volunteer



Volunteer Application 

We are looking for volunteers in the M
obile, Huntsville, Birmingham areas.

VOLUNTEERS NEEDED

The Epilepsy Foundation of Alabama is planning several events. Volunteers are needed to work and participate in the events. If you are interested in volunteering contact the Epilepsy Foundation of Alabama, Telephone 251-341-0170, 1-800-626-1582 or email cfoster@efala.org or complete the volunteer application on the volunteer page on our website.

 

Name:

Home Address: 

Office Address: 

 

Telephone Numbers  --   Home:   Work:  Cell:

Fax Number: 

Email Address: 

Occupation and Job Title:

Company:


Emergency Contact Information

 Person to Contact:    Relationship to Applicant: 

Primary Phone Number:    Secondary Phone Number:


Education:   

High School or GED   College Graduate  Advanced Degree    Other


Professional Affiliations:

Civic Affiliations:

 

Have you previously been employed or volunteered for the Epilepsy Foundation?  Yes   No

If "yes", when and where? 

 

 Special interest or talents you feel you bring as a volunteer:

Interest in epilepsy

  Personal (you or family member has epilepsy)    Professional    Community Betterment Other.

    Comments:

   

 

Please list previous Volunteer experiences. Include organization, your involvement and length of time you volunteered

Have you ever been convicted of a felony?  Yes  No

  If yes explain:

 

Briefly state why you would like to volunteer for the Epilepsy Foundation of Alabama

Areas of interest

   Clerical Assistance

   Fund Raising/Special Events 

   Public Awareness and Education

     Direct Client Services

 

List the name and address, phone numbers and e-mail address of 3 references who would recommend you below:

1.    Name:        Address:     

  Phone:        Email: 

 

2.    Name:        Address:    

    Phone:        Email: 

 

3.    Name:        Address:       

Phone:        Email: 

 

Notification/Disclaimer:

I understand that I am applying to be an unpaid volunteer for the Epilepsy Foundation of Alabama and that this application is not an application for employment. I understand that nothing in this application is intended to imply or create an employment relationship or a contract for employment.

For certain positions, the Epilepsy Foundation of Alabama may conduct background checks on potential volunteers if this would apply to you another form and more information will be required.

The information I have provided on this application form is true and complete. I hereby give the Epilepsy Foundation of Alabama the right to check my references and release the Epilepsy Foundation of Alabama and all persons supplying such information from liability.

I understand that if any misrepresentation has been made by me, I may be disqualified for consideration or dismissed if discovered later.

If accepted to the Epilepsy Foundation of Alabama’s volunteer program, I understand that I volunteer at the discretion of the Epilepsy Foundation of Alabama, and that I will abide by all the requirements of the program, policies and procedures of the organization. I also agree to keep any client information obtained directly, indirectly or just overheard confidential.

 

 I am interested in becoming a volunteer, have read and agreed to the statements above, and give the Epilepsy Foundation of Alabama the permission to process my application.

    Type your Intials here to indicate your interest and agreement: