Secure Volunteer Form

All your information is safe, encrypted, and not shared with anyone!

WHC is not affiliated with any government agency nor do we share data with any external agencies from this form in any way.

Your name

Email address

Phone number

Date field

Are you a veteran?

Yes No

If yes, please provide details

How did you hear about WHC?

Please summarize your skills

What is your availability to serve (within a 24/7 timeframe)?

WHC works with hospice and co-hosts training, conducts background checks and does routine drug testing to ensure public and personal safety. Are you willing to submit to these as a precondition before you are able to serve as a volunteer?

Yes No

Have you ever been convicted of a felony offense?

Yes No

If yes, please explain

Are you a registered sex offender?

Yes No

If yes, please explain

Are you an alcoholic?

Yes No

If yes, are you sober now and for how long have you been sober?

Have you been diagnosed with PTSD?

Yes No

If yes, please briefly explain your struggle and symptoms

Do you have any disabilities?

Yes No

Please explain

Have you been mandated community service hours?

Yes No

If so, please tell us how many hours are needed and the date they must be completed by:

If so, provide a brief summary of the offense committed and any special instructions/requirements:

Please explain why you want to help veterans.

Please paste your resume/biography in the space provided below:

Please Summarize What You Would Like to do with us:

Short and sweet, what's the bottom line?

Your information will be encrypted.

Secure Volunteer Form

All your information is safe, encrypted, and not shared with anyone!

All your information is safe, encrypted, and not shared with anyone!

Warrior Healing Center