Volunteer Registration

Please fill out form with necessary information and click the submit button below.

Personal Information

First Name

Middle Name

Last Name

Birth Date (required by State Office for Background Check)

Gender

Veteran

Address

Address Ln 2

City

State

Zip

Cell Phone (Primary)

Phone (Alternate)

Email Notifications

Primary Position

Password (Minimum of 6 Characters)

Password (verify)

Other Tasks you are Interested in

(List of Tasks includes: Captain, Crew, Boat Maintenance, Management, Promoting, Web Page Maintenance, Photo Uploading, Scheduler, Fund Raising, Party Organizer, Report Collection/Delivery, Data Entry, Guest Scheduling, Patient/Caring, Training)

Other Notes or Considerations

Employer Information

Name

Phone

City

State

Zip

Emergency Contact Information

Name

Relationship

Phone

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