Planned Parenthood South Atlantic - Volunteer Application

Are you 18 years or older?✱
- Yes
- No
Please tell us why you want to volunteer as a Patient Greeter at Planned Parenthood South Atlantic.✱
Please list the days and times that you are available to volunteer.✱
Please share any previous applicable volunteer experience, or experience with a reproductive health care provider you have.✱
Do you have interest in becoming a Patient Greeter Lead? The Patient Greeter Lead is a liaison between PPSAT Volunteer Coordinators and the rest of the Greeter Team coordinating pre-shift group communications and managing volunteer shift sign-ups.✱
- Yes
- No
Please describe any accessibility needs that you would like us to be aware of.

Please list an emergency contact by Name, Relation, and Phone number:✱
Have you spoken with an Planned Parenthood Employee about volunteering? If so please list their name here:

I have given Planned Parenthood South Atlantic true and complete information on this application. I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give Planned Parenthood South Atlantic permission to contact previous employers, references, and others, and hereby release Planned Parenthood South Atlantic and its employees, directors and officers from any and all liability as a result of such contact. I acknowledge that all volunteerism at Planned Parenthood South Atlantic is at-will. I understand that volunteering with Planned Parenthood South Atlantic is contingent upon a background check that may include sex offender registry, social media accounts, and general reputation.✱
- I understand that by checking this box constituted a legal signature confirming that I acknowledge and agree to the Applicant Statement.

Volunteer Application - Patient Greeter