Makom Volunteer Application

Makom Volunteer Application
At Makom, we support and empower people with IDD to achieve the quality of life to which they aspire. We encourage the participation of volunteers who support our mission and are willing to contribute. The information provided through this form will be kept strickly confidential and will help us determine the most satisfying and appropriate volunteer opportunity for you.
Volunteer Name

PrefixFirst NameMiddle NameLast Name
Email
example@example.com
Phone Number
Phone #Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Educational Background
College/School
Department/Field
Current Company
Title
What kind of volunteering are you interested in?*
Please indicate any specific departments, groups you are interested in and your availability.
Please indicate any specific departments or groups you are interested in volunteering with at Makom? *
Please indicate any specific departments or groups you are interested in volunteering with at Makom?
Do you have any volunteering experience? If yes, please describe.
Do you have any volunteering experience? If yes, please describe.
Availability*

MondaysTuesdaysWednesdaysThursdaysFridaysSaturdaysSundays
From

Hour Minutes

AM/PM Option
To

Hour Minutes

AM/PM Option
Comments
Any other information please include here.
Date of Application

MonthDayYear
Additional Information

Upload if applicable
Cancelof
Acknowledgements:

I understand I must sign Makom's Volunteer Code of ConductI understand that if age 18 years or younger, Makom will require a Parental Consent.I understand that all volunteers are subject to background screenings as required per regulatory requirements (MD-DDA and VA-DBDHS)
Should be Empty:

Makom Volunteer Application

Educational Background