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Volunteer Interest Form
Thank you for your interest in volunteering with Empowering the Ages!
Please complete this brief application, and ETA staff will be in touch with you soon.
**THIS FORM IS FOR INDIVIDUALS**
If you are a leader of a group of volunteers, please email
joslyne@empoweringtheages.org
for more information.
Contact Information
I am a(n):
*
Adult
Child (under 18)
Name (Child)
First Name
Last Name
Name (Adult)
*
First Name
Last Name
Above Adult is the Child's parent/guardian?
Yes
No
Preferred Phone Number
*
Phone Type
*
select one
Cell
Home
Work
Email
*
(We will add this email to our mailing list to receive our monthly e-newsletter, to keep you informed of new resources and volunteer opportunities. You may opt out at any time using the link at the bottom of each e-newsletter. We will not share your email or other contact information.)
Verify Email
*
Home Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Birthdate
*
Why? Because our mission is intergenerational, many of our volunteer groups are based on age. Also, we like to email you happy birthday.
Emergency Contact Info
Note: ETA will not contact this person unless there is an emergency.
Name
*
First Name
Last Name
Phone
*
Email
*
Verify Email
*
Volunteer Details
How did you hear about volunteering with ETA?
*
Through a friend or family member
ETA staff presentation / outreach
ETA's e-Newsletter (email)
Google / Internet search
Community listserv or other email
Montgomery County Volunteer Center
Newspaper or news website
Social Media - Facebook
Social Media - Instagram
Social Media - LinkedIn
Other
Volunteer Interests
*
ETA's volunteer opportunities vary over time, and as community needs change. Please let us know which kinds of volunteer settings appeal to you IN GENERAL, so we know which opportunities to share with you now and in the future. (Check as many as apply.)
volunteering that is 100% virtual (over Zoom or phone, from anywhere in the U.S.)
volunteering in-person in the Maryland/DC area
with preschool/K children
with elementary age children
with middle school age children
with high schoolers
with people age 50+
volunteering behind the scenes / administrative work
Other Volunteer Interests:
Availability
*
Please let us know which days and times you would consider volunteering IN GENERAL, so we know which opportunities to share with you now and in the future. (Check as many as apply.)
Weekdays - daytime
Weekdays - evenings
Saturdays
Sundays
Do you speak any language other than English?
*
English only
Spanish (beginner)
Spanish (conversational/advanced)
Spanish (fluent/native speaker)
Amharic
French
Other (please write in below)
Other - Language
Briefly describe any professional, volunteer, or personal experience you have interacting with people in other generations.
*
If none, you can write none -- it won't disqualify you!
Name two qualities that you would be able to bring to a relationship with someone in a different generation? (Two words only, please)
*
Last question! Do you have any comments or questions for us, about any aspect of volunteering with ETA?
Media Agreement
Consent Agreement
*
I give permission to ETA representatives to take photographs and video of me and/or of my minor child/children listed above during ETA-sponsored activities. I grant ETA full rights to use the images resulting from the photography/video, and any reproductions or adaptations of the images, for fundraising, publicity, or other purposes to help achieve ETA's aims. This might include (but is not limited to), the right to use them in ETA's printed and online publicity, social media, press releases, and funding applications. I understand that ETA will not include children's real names, addresses, or other identifying information along with these images online, in printed materials, or in other marketing/promotional materials.
Yes, I consent to these terms and conditions.
No, I do not consent.
Today's Date
*
(mm/dd/yyyy)
