OutReach LGBT Community Center
Volunteer Application
Please fill in your LEGAL Name
Please fill in name you would like us to use / Nickname:
Please let us know if there is name you would prefer us to use over your legal first name.
What is your PGP (preferred gender pronoun):
A preferred gender pronoun, or PGP, is simply the pronoun or set of pronouns that an individual would like others to use when talking to or about that individual. (Examples - He, Ze, Hir, They, Ve, She, Ey, Use of name only, Xe, etc)
Please fill in your home address. If you currently are without one, please fill in an address we can mail something to you.
Phone Number:
Do you prefer us to contact you through email or phone? Both?
Date of Birth:
What days are you available to volunteer?: 
Please enter the days you are available to Volunteer and What time of day works better. For example: "I am available Mon-Sat. I am available morning on Mon and Tues, Evenings on Wed, and Thurs and Fri I am available in the midday."
Current Employer: 
Who is your current employer? If you do not have one, please put "Not applicable."
Employer contact information:
Please fill in an email or phone number we can contact your employer and a name of someone we can contact. For example: "Susan, susan@anyjobsite.com, 608.555.1212"
Non-Personal Reference Name, Address, and Phone Number: 
Please add a non personal reference, including a way to contact them, and how you know them. "David, coworker, david@coworker.com"
How would you like to volunteer for OutReach?
Why are you interested in volunteering for OutReach?
What special qualities can you bring to OutReach?
What would you like to get out of your volunteering experience?
Volunteer Disclosure and Release Form

By signing the Volunteer Disclosure and Release form the applicant agrees:
1. To complete the Volunteer Application with factual information.
2. To disclose any criminal offense and/or convictions relating or equivalent to:
    * Any offense/crime involving murder
    * Any offense/crime (sexual, physical, emotional, etc.) involving children, the elderly, and/or persons with any type of disability
    * Any offense/crime involving illegal computer activity of any kind
    * Any offense/crime involving theft of any nature
    * Any offense/crime involving fraud of any kind
    * Any offense/crime involving drugs or alcohol
    * Any offense/crime involving assault (of any nature), domestic assault, disorderly conduct
    * Any offense/crime punishable as a Hate Crime
    * Any offense/crime of a sexual nature
3. To complete a successful background check.
4. To allow for the release of information to appropriate law enforcement agencies in order to conduct a background check
5. To agree to disclose any future criminal convictions or violations
6. To acknowledge the staff of OutReach, Inc. will complete an inquiry regarding references and previous volunteer experiences
7. To allow OutReach, Inc to perform at their discretion updated background checks
8. To acknowledge that if any background and/or general information inquiry discloses any misrepresentation on the Volunteer Application that indicates an individual us not suited for voluntary service for OutReach, Inc, the applicant shall be denied the voluntary position, or, if already placed, the volunteer employee will be immediately discharged.

It is important to note, that any offense/crime in any of the above listed areas will not immediately disqualify a person for volunteering. An open discussion between OutReach, Inc and the applicant will determine, case by case, if the applicant is suitable for the desired volunteer position. OutReach, Inc staff has the right to decline any volunteer application for any reason or unrelated to any offense/crime.

Volunteer Applicant's Legal Name:
By entering your legal name, you are agreeing to the above terms and conditions.
Looking for people who are bisexual, pansexual, omnisexual, fluid, queer, who don't use a label, or who are otherwise non-monosexual
We are looking for young adults who are interested in facilitating a young adult social support group that meets the 1st and 3rd Sunday of the month.
We are looking for someone who lives in Rock County to facilitate the monthly OutReach of Rock County social support group.

We are looking for many volunteers who can help with various pre-Pride events as well as day of events. PRIDE is Sunday August 20th. We will need early afternoon/late morning volunteers as well as those during the later afternoon.
The LGBT Senior Alliance is a joint program between OutReach and the Madison Senior Center. The LGBT Senior Alliance is looking for volunteers, preferably people over the age of 45, to help facilitate programming. 
Our LGBT Senior Advocate is looking for LGBT people over the age of 50 to volunteer with our Speakers Bureau. 
Volunteer Applicant's Legal Name:
By clicking this box, I understand I must complete a training depending on how I will be volunteering. Volunteers who work directly with clients must undergo an 8-hour training spread out over two or more days. The training is offered every other month at our agency. In 2017, the anticipated training months are August, October, December; days to be determined. The volunteer training if offered approximately every other month. The next training will take place in early September.
Group Facilitator for one of these groups:
Front Desk Volunteers for one/some/all of these shifts:
OutReach of Rock County
LGBT Senior Alliance
Wednesdays 2:30-5pm
Wednesdays 5-8pm
Wednesdays 12-2:30pm
Thursdays 12-2:30pm
Thursdays 2:30-5pm
LGBT Senior Advocate Volunteers