Volunteer Registration Form

1
Are you over 18?* This field is required.
YESNO
2
What is your date of birth?* This field is required.
Date
Year
Month
Day
3
What is your legal name?* This field is required.
First Name
Last Name
4
What name do you prefer?* This field is required.
First Name
Last Name
5
What gender pronouns do you prefer?
She/Her
He/Him
They/Them
6
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
7
What's the best email address for you?* This field is required.
8
Phone Number* This field is required.
Area Code
Phone Number
9
Have you ever been convicted of a felony?* This field is required.
YESNO
10
Please explain further here.
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11
Are you volunteering for community service hours?* This field is required.
YESNO
12
Is this court-ordered, or for school?* This field is required.Please choose one.
Court-ordered
School
13
What school or college do you go to?* This field is required.
14
When must your community service hours be completed by?* This field is required.
Date
Year
Month
Day
15
What is the number of community service hours you need to complete?
16
What are you looking to gain/achieve by volunteering at the LGBTQ Center OC?* This field is required.
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The LGBT Center OC seeks to advocate on behalf of the Orange County LGBTQ community to and provide services that ensure its well-being and positive identity. What sort of impact do you personally want to make within our community?
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Ok
18
Are you currently working?* This field is required.
YESNO
19
Please describe your current job.
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20
Please tell us about your skill set or work experience as well as any special interests you may have.
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21
How would you like to help? Please be aware that openings are subject to availability.* This field is required.Select up to three.
Facility Support: For those experienced and/or licensed in areas of construction and handyman services to repair and maintain the Center.
Front Desk: Provide clients with resources, answer incoming calls, and greet walk-in clients and visitors to our CyberCenter and LGBTQ Library.
Immigration Resources: Provide education and outreach regarding DACA and other immigration issues (Bilingual preferred--Spanish or other languages. 3 month or 60 hour commitment.)
Internship (Mental Health Counseling): Must be enrolled in or have already completed a master's in counseling or similar degree. Please send cover letter and resume to kel.williams@lgbtqcenteroc.org and skip completing this application.
Internship (General/Other): For general non Mental Health internships send a cover letter, resume, school information, program requirements, and why the LGBTQ Center to chandelle.loop@lgbtqcenteroc.org
Outreach and Civic Engagement: Represent the LGBTQ Center OC in the community at fairs, colleges, and other settings. This follows mostly a Monday through Friday school hours schedule, with occasional Saturday events.
Peer Group Facilitation: Help structure and facilitate the weekly and monthly discussion groups, and attend quarterly group facilitator meetings. Experience with group facilitation or peer counseling is helpful but not required.
Special Events (Staffing): Assist with staffing fundraisers and other special events. Provide details on interest in being on the Events Committee (2nd & 4th Thursday 6:30pm-8:30pm). Requires 12 month commitment and roughly 150 hours total.
Trans* Services: Help provide transgender-inclusive and supportive environment by being a part of our Trans Committee. This committee meetings the 1st & 3rd Mondays of the month from 7pm to 8:30pm. We request a 12 month commitment and roughly 150 hours total.
Skill-Based Volunteering
22
Of the volunteer opportunities above, which would be your first choice?* This field is required.Please select one.
Facility Support
Front Desk
Immigration Resources
Internship (Mental Health Counseling)
Internship (General/Other)
Outreach and Civic Engagement
Peer Group Facilitation
Special Events (Staffing)
Skill-Based Volunteering
Trans* Services
23
Please indicate which of the following additional skills you could offer as a volunteer.Choose all the ones that suit you well
Bartending
Bookkeeping/Accounting
Event Planning
Finance
Graphic Design
HR Support
IT Support
Serving/Catering
24
Is there anything else you feel we should know about your skill set or training?
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25
What special needs (that might affect your ability to volunteer), if any, would you ask us to accommodate?
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26
On what days are you available?* This field is required.Choose all the ones that suit you well.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
27
What is your general availability?* This field is required.
Weekly
Bi-weekly
Monthly
28
At time of day do you tend to be free?* This field is required.Please choose one or more.
Morning 10am-2pm
Afternoon 2pm-6pm
Evening 6pm-9pm
Flexible
29
How often would you like to volunteer?
One-time
Once a week
Once a month
Twice a month
Occasionally
30
When are you available to begin your training and volunteering?* This field is required.NOTE: Due to a high volume of applicants, please allow up to three weeks for your training to be scheduled.
Date
Year
Month
Day
31
Is there anything additional we should know about your availability?
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32
Confidentiality Agreement* This field is required.As a volunteer with the Gay and Lesbian Community Services Center of Orange County ("LGBT Center OC"), I understand that in the course of my work, I may learn certain facts about individuals that are of a highly personal and confidential nature. Examples of such information are, but limited to: medical condition and treatment, finances, living arrangements, employment, sexual orientation, relations with family members, etc. I understand that all such information must be treated as completely confidential. I agree not to disclose any information of a personal nature to any person not also affiliated with the LGBT Center OC or authorized by the LGBT Center OC to have such information, without the specific consent of the individual to whom such information pertains. I understand that the above applies not only to clients, but to volunteers and staff as well. Examples of such information are volunteers’ names, addresses, staff vacation records, staff salaries, and other personal record information. I understand and agree that all such information is strictly confidential and is not to be revealed to any unauthorized source. I also understand that, in the course of my volunteer service, I may learn certain facts about the LGBT Center OC that are considered proprietary information. Examples of proprietary information include, but are not limited to, proposed scopes of work, strategic plans, mailing lists, fundraising plans, and other administrative plans, records. I understand all such information is confidential is not to be revealed to any unauthorized source. I understand that failure to comply may result in termination of my volunteer service.
I acceptI do not accept
33
Indemnification* This field is required.I understand that as a volunteer, I am not covered under workers' compensation and that the Gay and Lesbian Community Services Center of Orange County ("LGBT Center OC") assumes no liability for injuries or other losses that may occur during or in any way related to my volunteer service time. I also understand that volunteers working on-site at The Center OC, or at offsite activities sponsored by the LGBT Center OC, shall indemnify, hold harmless and defend the LGBT Center OC from any loss, liability, claim, lawsuit, injury, expense or damage whatsoever, including but not limited to medical costs, attorneys fees, and court costs.
I acceptI do not accept
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