Volunteer Application Form for Walton Empowers

Volunteer Application Form
Thank you for your interest in volunteering with Walton Empowers. Our volunteers play a vital role in supporting individuals and families impacted by substance use and recovery challenges.

The information provided through this form will be kept confidential and will help us determine the most satisfying and appropriate volunteer opportunity for you. Please complete the application below. We will review your submission and contact you regarding the next steps.
Personal Information
Name

PrefixFirst NameLast Name
Birth Date

MonthDayYear
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferred Method of Contact
Occupation
Company
Department/Position
Availability
Select your available days
Times available
Areas of Interest
In which areas would you like to volunteer?
Which of the volunteering activities interest you?
Additional notes about your schedule
Do you have any volunteering experience? If yes, please describe.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Volunteer Application Form