Volunteer Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for your interest in volunteering with Imerman Angels! We would be honored to have you a part of our team!

Please complete the following form and we will contact you with open opportunities as soon as possible. Thank you again for helping ensure no one faces cancer alone!

Email *

First and Last Name: *

Age: *

Date of Birth: *

YYYY

Demographic Information

It's important to us to know the community, volunteers, and interns we work with, so we can best serve them. By providing this information, we can get a greater sense of who you are in order to provide the best experience with our organization.

Information provided will be kept anonymous and you can decline to answer any of these questions. Please respond as best you can.

While we are trying to be inclusive for each of the questions below, we recognize there could be errors. If you find these options to be limiting, please select "Prefer to self identify" and let us know how you identify in the open-text question.

Which category best describes your race/origin? (select all that apply)

American Indian or Alaska Native

Asian

Native Hawaiian or Other Pacific Islander

Hispanic/Latinx

Black or African American

Multi-racial

White

Prefer not to disclose

Prefer to self identify

Please share additional and more detailed information on how you self identify so that we can provide a more meaningful opportunity (optional)

Gender Identity (select all that apply)

Female

Male

Nonbinary

Transgender

Prefer not to disclose

Prefer to self Identify

In your own words, what is your gender identity? (optional)

Personal Pronouns (optional; select all that apply)

He/Him/His

She/Her/Hers

They/Them/Theirs

Ze/Hir/Hirs

No pronoun

Prefer not to disclose

Prefer to self identify

In your own words, what are your personal pronouns? (optional)

City, State *

Occupation:

Phone Number:

Why would you like to volunteer with Imerman Angels? *

Have you, or someone close to you, been affected by cancer? *

We want to utilize you and the skills that make you special! Please share your superpower skills that will enhance our team:

How many hours during the workweek (Mon-Fri 9AM-5PM Central Time) can you spend with Imerman Angels?

None

2-4 Hours

4-6 Hours

6-8 Hours

8-10 Hours

10 or More Hours

Clear selection

Check the following areas in which you would like to help Imerman Angels:

Cancer Intake & Support (Remote)

Bilingual Cancer Intake & Support (Remote)

Testimonial Outreach (Remote)

Social Media Advocate (Remote)

Do you speak another language fluently?

Yes

Clear selection

If yes, what language?

Please click the link below to join our Facebook Volunteer group to stay up to date on new opportunities and insights into Imerman Angels! https://www.facebook.com/groups/imermanvolunteers

Clear selection

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Imerman Angels. Report Abuse

Forms