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2. 

3. Thank you for your interest in serving your community. By completing this form, you can assist us in connecting you with the appropriate County Department or community service agency.   This form is to express interest only; staff will reach out once your information is received to provide you with more details on volunteer opportunities in your area of interest.

   Thank you again for your willingness to make a difference! 

   
   

5. Name
6. Email Address
8. Address
10. City
11. State
12. Zip Code
14. Phone Number
15. Cell Number
17. Areas You'd Like to Volunteer In *

    1. Seniors/Those in Need
    2. Landscaping/Gardening on County Properties
    3. Fire, EMS, Law Enforcement
    4. Animal Shelter
    5. Library/Recreation/Literacy
    6. Litter Clean Up
    7. Other

    Check all that apply.

18. What is the best time of day to contact you? *
20. If other, list areas in which you'd like to serve:
22. How Much Time Would You Like to Share?

    1. 10 or more hours a week
    2. A few hours a week
    3. A few hours a month
    4. A one-time day activity or event
    5. As needed
24. Special Skills

    Please list any special skills or talents that can apply to your volunteer work. 

28. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    By signing electronically I acknowledge that this form is to express volunteerism interest only. I understand that affiliated agencies will have their own missions, values, policies and protocols to ensure the safety and health of  residents, staff and volunteers. I agree to be contacted and connected with agencies that align with the volunteering work I wish  to pursue. I acknowledge that Campbell County, its staff,  agents, and Board/Commissions are saved harmless from any injury, loss, or dispute I encounter if selected as a volunteer. I agree to a background check and am willing to complete any required paperwork necessary for volunteerism in Campbell County.  

    1. I agree.
30. Electronic Signature
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field