Click image to print a blank form
If you are under 18, use the pdf paper application so your parent or guardian can sign it and mail it to us.
Have trouble with the on-line form? Click to print a pdf paper application and mail or bring it to us.
First Name: (required) Last Name: (required)
Address 1: (required) Address 2:
City: (required) State: (required) Zip: (required)
Home Tel: (required) Home Fax:
Pager: Cell Phone:
Date of Birth: (required)
Emergency Contact: Emergency Phone:
Place of Employment: (required)
Full TimePart TimeOther
Work Phone: Ext:
Counselor / Teacher:
How did you hear about ComputerCorps? (required)
Why do you want to volunteer? (required)
Have you volunteered before?
Yes:No: If Yes, please give details:
Please provide a brief description of your work history: (required)
What type of computer do you have? (required)
Check Type(s) of Volunteer Work Desired (required)
TraineeComputer TechnicianWeb Page DesignWeb Based EditorialsProgrammingSoftware InstallationComputer RepairGraphic DesignSoftware TrainingMonitor RepairComputer MaintenanceComputer NetworkingForum and Chat SysOpNO Technical
Telephone CallsTyping / Data InputSecretarialOffice WorkPublic RelationsOrganizingFundraisingBookkeepingAdvertisingLegal WorkAccountingNO Administrative
PaintingGardeningJanitorial WorkMisc Labor WorkDriving VehiclesCooking / ChefPlumbing WorkElectrical WorkLandscapingCarpentry WorkWarehouse WorkNO Facilities
Days When Possibly Available (This is Not a Commitment)
#1 Reference Name: (required)
#1 Reference Relationship: (required)
#2 Reference Name: (required)
#2 Reference Relationship: (required)
#3 Reference Name:
#3 Reference Relationship:
The ComputerCorps mission is to help others and the community. All volunteer duties are to be performed with the spirit of teamwork, co-operation and kindness. Volunteers not abiding by these rules will be asked to leave.
Additional Guidelines for Volunteers under the age of 18 years
I acknowledge that by participating in different volunteer duties the risk of physical injury is present. I further acknowledge that the programs of ComputerCorps are primarily administered by individuals who volunteer their time rather than paid professionals. In consideration for ComputerCorps accepting the above named individual & permitting the voluntary participation of said individual in its programs, I hereby release, discharge, & hold harmless ComputerCorps, its employees, volunteers & any other entities and/or representatives from any claims arising out of or relating to any physical injury that may result to said individual while participating in ComputerCorps sponsored events, including any physical injury caused by the negligence of any supervisors while performing his or her duties during any functions. I further acknowledge that I am only a volunteer and that any benefits or perks that I receive as a result of my participation do not constitute an employee employer relationship. I acknowledge that I have read and fully understand the above and that the information that I have provided is true and correct.
Have you ever been arrested? (required)
Have you ever been convicted of a felony? (required)
If Yes to either of the above, give details: (required)
At various times ComputerCorps and its volunteers work with children, sensitive data and costly computer components. Because of this work, it is often necessary to run background checks on the volunteers with local, state and / or federal agencies. Volunteers may also be requested to have their picture and / or fingerprints taken and to provide a copy of their picture ID for ComputerCorps files. All information provided will be kept as confidential as possible.
By clicking the statement below, you acknowledge you are 18 years or older, accept of the terms of our relationship, submit the information above and state that all information is true.
ComputerCorps is an internationally recognized A 501(c)(3) Non-Profit, ComputerCorps provides computers and training for under-served families, by refurbishing and recycling donated electronic waste.