IF POSSIBLE DO NOT CONTACT DDA BY TELEPHONE. IT IS EASIER FOR US TO RESPOND AND CONTACT YOU BY E-MAIL. YOU CAN GET A FREE E-MAIL ADDRESS AND HELP USING E-MAIL VIA YOUR LOCAL PUBLIC LIBRARY, IF YOU DON'T HAVE E-MAIL.
E-mail us: DDAvolunteers@comcast.net



What is your name?

*What is your email address?

Address:
City:     Country:

 Zip/mailing code:      Telephone or cell:     
Fax:
Are you representing a group of people wanting to volunteer? Yes No
Fill in only those that apply please:
Your age if you are only volunteer:    
Representative/mean age of group of volunteers:
Are you or your group:  Male: Female: Mixed:
Time you are available:
Days you are available:
Write in day, month and year when you want to start your volunteer work:
Write in day, month and year for completion
deadlines for your volunteer work:

Click only those that apply please:
Are you doing court ordered community service?
Are you doing volunteer work as part of school project:

Are you doing volunteer work for any other reason(s) which you thin
we should be aware? If so fill in details below:



If you are you doing court ordered community service
:
1. How many hours total do you need for this?
2. What is the date by which you need to complete this work?
 DAY:   MONTH:   YEAR:

Have you volunteered in the past? If so please fill in details of other organizations
you have volunteered with below:

 

 



 

MANDATORY: Please write in the County and State in
which the offense for which you are court
ordered to do volunteer service occurred:

 

MANDATORY: Please write in the specific court
that ordered you to do volunteer
service, and the date of this order:

 

MANDATORY: Please write in the name of the person or probation officer
in Community Corrections who is supervising your community
service and also write in the contact info,
inclusive of phone, fax and e-mail for this person:

 

MANDATORY: Please state the type of
offense CLICK ALL THAT APPLY PLEASE)
for which you are court
ordered to do volunteer service:

• FELONY THEFT:

• MISDEMEANOR THEFT:

• ALCOHOL ABUSE OR DWI:

• DRUG RELATED OFFENSES:

• CRIME THREATENING OR INVOLVING THE
USE OF PHYSICAL VIOLENCE OR FORCE:

• CRIME INVOLVING MENTAL, EMOTIONAL, FINANCIAL,
SEXUAL, AND/OR PHYSICAL ABUSE OF
VULNERABLE PERSONS OR CHILDREN:

MANDATORY: DO YOU HAVE MENTAL HEALTH PROBLEMS: Yes No

MANDATORY:
IF SO, ARE YOU BEING TREATED BY A LICENSE
MENTAL HEALTH PROFESSIONAL?
Yes No

MANDATORY: IF SO, DO YOU AGREE TO OUR CONTACTING YOUR MENTAL HEALTH
PROFESSIONAL TO HELP YOU WITH COMPLETION OF YOUR VOLUNTEER SERVICE
IF WE ACCESS YOU ARE HAVING DIFFICULTIES WITH THE VOLUNTEER SERVICE?

Yes No

 

MANDATORY: Please write in ANY OTHER PROBLEMS YOU HAVE
THAT COULD IMPACT ON YOUR VOLUNTEER SERVICE AND
STATE ANY SPECIAL NEEDS YOU WOULD LIKE OUR
ORGANIZATION TO PROVIDE TO ASSIST
YOU WITH YOUR VOLUNTEER SERVICE:

 

We need the above information to expeditiously, safely and effectively provide good and interesting volunteer opportunities for offenders, access risk, and protect all parties inclusive members and the community.

 

 

Your experience:

LEGAL
ATTORNEY
CIVIL RIGHTS

CRIMINAL

GOVERNMENT

INTERNATIONAL

SOCIAL SECURITY

STATE WELFARE

LEGAL RESEARCH

PARALEGAL

ORGANIZATIONAL:
FINANCIAL PLANNING

ACCOUNTING

PUBLIC RELATIONS

SUPERVISING

ADMINISTRATION

VOLUNTEER PROJECTS

FUND RAISING

PROMOTION/MARKETING

COORDINATION

GRANT WRITING

PUBLICITY

OFFICE:
BOOKKEEPING
ACCOUNTING
DATA PROCESSING
TYPING
ELECTRONICS REPAIR
FILING
SECRETARIAL
PC PUBLISHING
COMPUTER NETWORKING
CARPENTRY AND REPAIRS
CLEANING
ELECTRICAL
PLUMBING
COMPUTER REPAIR

MULTIMEDIA:
PRINT DESIGN
WEB DESIGN/CODE
JOURNALISM
RESEARCH
VIDEO
TELEVISION
STAGE DESIGN
COPY WRITING
PRODUCTION
GRAPHICS
WEB PROMOTION
E-COMMERCE
PRINTING
MEDICAL:
FORENSIC

ENDOCRINOLOGY

ONCOLOGY

PSYCHIATRY

PSYCHOLOGY

NURSING

PERSONAL CARE

PHYSICAL THERAPY

SOCIAL/SPIRITUAL:
MINISTER

PSYCHIC HEALING

PSYCHIC

TAROT

ASTROLOGY

RUNES

CHANNELING

SPIRIT CONTACT

INTUITIVE
GRIEF COUNSELING

SOCIAL WORK

COMPLEMENTARY:
CHIROPRACTOR
TOUCH THERAPY
REIKI
ACUPUNCTURE
AROMA THERAPY
MASSAGE
SPIRITUAL ART
SOUL RETRIEVAL

OTHER SKILLS:

Your availability including days of the week and times each day that you are
available, transportation, and any other scheduling requirement:
Do you have a pick-up or van to use for transportation/volunteer
work when volunteering: Yes No
Do you have health insurance that covers you for any accidents that may
occur when volunteering: Yes No
Other info about you, e.g. volunteer work preferred, and other: communication/response:
Information Required/Requested:

CLICK HERE TO READ ALL SPECIFIC TERMS AGREED TO BY SUBMITTING
THIS FORM - RELEASE AND WAIVER OF LIABILITY

By completing this form do you agree iN ADVANCE TO WAIVE ALL CLAIMS AGAINST DDA regarding
all volunteer work , in all aspects and respects, done for Diabetics/Disabled Anonymous: Yes No

CLICK HERE TO DOWNLOAD YOUR COPY OF THIS RELEASE AND WAIVER


CLICK HERE TO READ ALL SPECIFIC TERMS AGREED TO BY SUBMITTING
THIS FORM - CONFIDENTIALITY AND NON-DISCLOSURE

By completing this form do you agree in advance to complete/absolute confidentiality regarding
all volunteer work , in all aspects and respects, done for Diabetics/Disabled Anonymous: Yes No

CLICK HERE TO DOWNLOAD YOUR COPY OF THIS CONFIDENTIALITY AND NON=DISCLOSURE AGREEMENT

Is this communication urgent? Yes No

Date response needed by:  DAY:   MONTH:   YEAR:

BY SUBMITTING THIS FORM YOU AGREE TO ALL THE TERMS OF THE
LIABILITY WAIVER AND CONFIDENTIALITY SHOWN IN
LINKS AND DOWNLOADS OF AGREEMENTS IN FULL