Volunteer Application
Contact Information
Full Name:
First
Last
Address
Street Address
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Zip or Postal Code
Country
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Cuba
Cyprus
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Dominican Republic
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Nigeria
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Pitcairn Islands
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Portugal
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Serbia and Montenegro
Seychelles
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Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
St. Helena
St. Kitts and Nevis
St. Lucia
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Sudan
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Taiwan
Tajikistan
Tanzania
Thailand
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Tonga
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Preferred Phone
Preferred Phone Type
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Home
Work
Mobile
Other Phone
Email Address
How did you hear about Imerman Angels? (select all that apply)
TV
Radio
Social media
heard from a friend or family member
brochure
Demographic Information
Date of Birth
Some opportunities require volunteers to be at least age 18 or 21.
Gender
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Male
Female
Ethnicity
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African-American
American-Indian
Asian-Indian
Caucasian
Chinese
Filipino
Guamanian or Chamorrow
Hispanic
Korean
Native Hawaiian
Other Asian
Samoan
Vietnamese
Decline to Answer
Optional - for grant reporting
Employment Status
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Disability
Full-Time
Part-Time
Retired
Homemaker
Unemployed
Other
Employer
Occupation
Employment Industry
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Accounting
Admin - Clerical
Automotive
Banking
Biotech
Business Development
Business Opportunity
Construction
Consultant
Customer Service
Design
Distribution - Shipping
Education
Engineering
Executive
Facilities
Finance
Franchise
General Business
General Labor
Government
Government - Federal
Grocery
Health Care
Hospitality - Hotel
Human Resources
Information Technology
Installation - Maint - Repair
Insurance
Inventory
Legal
Legal Admin
Management
Manufacturing
Marketing
Media - Journalism - Newspaper
Nonprofit - Social Services
Nurse
Other
Pharmaceutical
Professional Services
Purchasing - Procurement
QA - Quality Control
Real Estate
Research
Restaurant - Food Service
Retail
Sales
Science
Skilled Labor - Trades
Strategy - Planning
Supply Chain
Telecommunications
Training
Transportation
Veterinary Services
If "Other", please let us know what your employment industry is
Upload Photo (optional)
Volunteer Information
How has cancer touched your life?
I have/had cancer
a family member or friend has/had cancer
other
If "other" please explain
Please explain how cancer has touched your life.
Why Imerman Angels?
Thank you for taking the initiative to volunteer for Imerman Angels! We realize there are many ways you could spend your free time, why us?
Interests
What type of projects or volunteer opportunities are you interested in?
Availability
Please select...
1 year or more
6-12 months
3-6 months
1-3 months
What is your availability for volunteering?
Frequency
Please select...
Several times per week
Once per week
Once per month
Several times per year
Other
How frequently can you volunteer?
Skills and Experience
Accounting
Athletic Training
Copy Writing
Corporate Sponsorship
Curriculum Development/Training
Event Planning
Grant Writing
Graphic Design
Health Care
Hospitality
Marketing
Office Management
Promotions
Project Management
Public Relations
Public Speaking
Strategic Planning
Social Work
Tech Support
Vendor Negotiation
Volunteer Management
Web Design
Other
Skills, experience and background that you think might be helpful to IA. You'd be surprised how many skills prove helpful to us - so don't be afraid to add things to the "other" field.
If "other" please explain:
Fluent Spoken Languages
Amharic
American Sign Language
Arabic
Armenian
Bengali
Cantonese
Croatian
Czech
Danish
Dutch
English
Finnish
Formosan
French
French Creole
German
Greek
Gujarathi
Hebrew
Hindi (Urdu)
Hungarian
Ilocano
Italian
Japanese
Korean
Kru
Lithuanian
Malayalam
Mandarin
Miao
Mon-khmer
Norwegian
Panjabi
Persian
Polish
Portuguese
Serbocroatian
Slovak
Spanish
Swedish
Romanian
Russian
Samoan
Syriac
Tagalog
Thai
Turkish
Ukranian
Vietnamese
Other Fluent Language(s)
If you selected "Other Fluent Language", what language(s)?
Fluent Written/Read Languages
Amharic
American Sign Language
Arabic
Armenian
Bengali
Cantonese
Croatian
Czech
Danish
Dutch
English
Finnish
Formosan
French
French Creole
German
Greek
Gujarathi
Hebrew
Hindi (Urdu)
Hungarian
Ilocano
Italian
Japanese
Korean
Kru
Lithuanian
Malayalam
Mandarin
Miao
Mon-khmer
Norwegian
Panjabi
Persian
Polish
Portuguese
Serbocroatian
Slovak
Spanish
Swedish
Romanian
Russian
Samoan
Syriac
Tagalog
Thai
Turkish
Ukranian
Vietnamese
Other Fluent Language(s)
If you selected "Other Fluent Language", what language(s)?
Additional Comments:
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