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VOLUNTEER FORM
VOLUNTEER FORM Please complete section 1 and 2 (Waivers)
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* Indicates required question
Valid Email
*
Your answer
First Name
*
Your answer
Last Name
*
Your answer
Phone Number
*
Your answer
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
COUNTY
*
Your answer
T-Shirt Size (pick 1 size only)
*
S
M
L
XL
XXL
XXXL
Thank You but I do not want a t-shirt
Other:
Will you be available for the entire camp session? Click on Yes. If you can only stay part of the time, please select Other and include timeframe (ie: 9-11)
*
Yes
No
Other:
Volunteer status
*
Student - Georgia State University OT Program
Student - name of school and program in Other
Health Care Professional - GSU OT Department
Individual volunteer
Other:
Required
Current Age (Request for grant funding)
*
Your answer
Date of Birth (Requested for grant funding-Not Required)
MM
/
DD
/
YYYY
Gender* (Requested for grant funding)
*
Female
Male
Prefer not to say
Other:
Required
Race (Requested for grant funding)
*
White/Caucasion
African American/Black
Hispanic
Asian
Prefer not to say
Other:
Required
Comments or NA
*
Your answer
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