Volunteer

Volunteer Form

  • Contact Information

  • Must put one - Mr./Mrs./Ms./Miss/Dr.
  • Volunteer Preferences

  • Demographic Information

  • Date Format: MM slash DD slash YYYY
  • Education

  • References

    If you are under 18 years of age, you must provide at least one school-related reference
  • NamePhoneAddress 
    Add a new row
  • NamePhoneAddress 
    Add a new row
  • NamePhoneAddress 
    Add a new row
  • Internship or Community Service

    Optional*
  • NamePhoneEmail 
    Add a new row
  • Volunteer Agreement

  • - I understand that all protected information and data about clients, agencies, volunteers, associates and donors of the Arc of Steuben is strictly confidential and may not be discussed outside the office, or with any unauthorized person.
    - Volunteers are required to have two (2) current PPD (TB) results, may have a child abuse clearance check, background check, and be subject to fingerprinting. PPD results can be obtained from a physician or school health office.

  • I grant full permission to the Arc of Steuben to use any photographs, film, video, or audiotapes of me performing volunteer work for any purpose the Agency deems appropriate.
  • I grant full permission to the Arc of Steuben to conduct a full background check, including NYS required Medicaid Exclusion Background Check prior to my volunteer service.
  • Signature of Parent/Legal Guardian if Volunteer is under 18
  • Date Format: MM slash DD slash YYYY