Volunteer Application

*Important Note*: The email address you use for the purposes of this application will be the main way that UHPP's Volunteer Coordinator will communicate with you. Check your Spam folder for emails from "madeliner@uhpp.org"

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* Today's date

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* First Name

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* Last Name

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* Pronouns

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* Address If you are uncomfortable providing your full address, please provide your Zip Code, as we identify volunteers for specific health centers based on your location.

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* Phone number

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* Email address If you are a student, please provide your personal email, rather than your school email, so that we can reach out with opportunities to volunteer even after you have graduated!

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* What is the best way to reach you?

Phone

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* Would you like to be added to UHPP's email list?

Yes, sign me up!

No, thank you.

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* Where are you based/Which PP Health Center is most convenient for you to get to for a volunteer opportunity?

Albany (855 Central Ave)

Troy (120 Hoosick St)

Hudson (804 Columbia St)

You are based in one area, but are willing to travel to another. For example: "I live in Troy but I am willing to and able to get to Albany and Hudson"

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* What is your occupation?

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* Employer school or attending?

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* Please list any knowledge and/ or personal experience you have with reproductive health care, advocacy and/or education.

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* Why do you want to volunteer with Upper Hudson Planned Parenthood?

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* Please check this box if you are interested in volunteering as a doula. If you are volunteering as a doula, you can disregard the next question.

Yes

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* Please rank our volunteer opportunities from (1) as being most interested in, to (7) being least interested in. If you want more context about what each of these roles entail, check out our website.

Abortion Access Navigator Assistant

Abortion Care Kit Assemblers

Childcare Provider

Community Outreach Tabling Volunteer

Teen Clinic Volunteer

Development/Fundraising Assistant

Patient Escort

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* What is your availability?

Weekdays

Nights

Weekends

Varies

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* Any restrictions on your availability?

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* Can you commit to the volunteer program for a specific amount of time?

Yes

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* If yes, how long?

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* Have you ever been convicted of a crime?

Yes

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* Today's date

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* First Name

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* Last Name

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* Pronouns

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* Address *If you are uncomfortable providing your full address, please provide your Zip Code, as we identify volunteers for specific health centers based on your location.*

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* Phone number

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* Email address *If you are a student, please provide your personal email, rather than your school email, so that we can reach out with opportunities to volunteer even after you have graduated!*

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* What is the best way to reach you?

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* Would you like to be added to UHPP's email list?

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* Where are you based/Which PP Health Center is most convenient for you to get to for a volunteer opportunity?

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* What is your occupation?

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* Employer school or attending?

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* Please list any knowledge and/ or personal experience you have with reproductive health care, advocacy and/or education.

Question Title

* Why do you want to volunteer with Upper Hudson Planned Parenthood?

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* Please check this box if you are interested in volunteering as a doula. If you are volunteering as a doula, you can disregard the next question.

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* Please rank our volunteer opportunities from (1) as being most interested in, to (7) being least interested in. If you want more context about what each of these roles entail, check out our website.

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* What is your availability?

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* Any restrictions on your availability?

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* Can you commit to the volunteer program for a specific amount of time?

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* If yes, how long?

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* Have you ever been convicted of a crime?

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* If yes, please explain:

* Address If you are uncomfortable providing your full address, please provide your Zip Code, as we identify volunteers for specific health centers based on your location.

* Email address If you are a student, please provide your personal email, rather than your school email, so that we can reach out with opportunities to volunteer even after you have graduated!