Volunteer Volunteer Only Name* First Last Where are you located?*SelectUnited StatesOutside of United StatesAddress* Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email* Phone*Total number of hours typically available to volunteer on a weekly basis.*Which days of the week are you typically available to volunteer?* Sunday Monday Tuesday Wednesday Thursday Friday Saturday Are you a native speaker in any language besides English?* Yes No Please list those languages.*Are you a interested in being a District Leader for your area?*SelectYes, I'm a interested.NoWhat is your occupation?SelectOtherAttorneyMedical ProfessionalDental ProfessionalJournalistMarketingAre you a doctor or nurse?* Doctor - MD or DO Nurse Other In what areas would you like to volunteer?* Fundraising Writing Clerical Social Media Legal Marketing Research/Treatment Website Video Production Designer/Illustrator Other (please detail below) Please describe your professional experience.*Please include any certifications or licenses related to this experience.Please tell us about why you would like to volunteer and detail any special talents that you could provide as a volunteer?Our promise to you: Your personal information will only be used by Children's Health Defense. Thank you so much for supporting Children's Health Defense! Δ
