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2024 New Volunteer Orientations are scheduled for October 1, 12:00 P.M. and 6 P.M., November 7 and December 4 at our Arch Street location: 1216 Arch St, 6th Floor starting at 6 P.M.

Volunteer Application (Must be 18+ & Out of High School to apply)

Name*
First Last
Address*
Street Address Apt # (If applicable) City State ZIP Code
Email*
Home Phone
Work Phone
Cell Phone*
Other Phone
Date of Birth*
You must be at least 18 years of age.
Gender
Pronouns*

Please share your pronouns
Criminal History*
Have you ever been convicted of a felony or misdemeanor?
- No
- Yes
Criminal History*
Please explain:
Emergency Contact*
First Last
Emergency Contact Phone*
Emergency Contact Relationship*
Secondary Emergency Contact*
First Last
Secondary Emergency Contact Phone*
Secondary Emergency Contact Relationship*
Volunteer Interest Area*
We will help you to choose a specific volunteer assignment later. For now, please indicate a general area of volunteer interest:
How did you learn about Action Wellness?*
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Age
You must be at least 18 years of age to submit this form.
Phone
This field is for validation purposes and should be left unchanged.

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Volunteer Application (Must be 18+ & Out of High School to apply)

Contact Us

Action Wellness Center City

Volunteer Application (Must be 18+ & Out of High School to apply)

Contact Us

Action Wellness Center City

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