Alliance for Positive Health

Today's Date *

Name (First, Last) *

Address *

City *

State *

Zip *

Phone Number *

Alternate Phone Number

What is the best way to reach you?

Mail

Phone

Occupation

Employer/School Attending

Please list any knowledge and/or personal experience you have with HIV/AIDS.

Why do you want to volunteer with the Alliance for Positive Health?

Please list any skills, interests, hobbies:

Have you ever been convicted of a felony?

Yes

If yes, please explain

Emergency Contact Name *

Emergency Contact Phone Number *

Emergency Contact Alternate Phone Number

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

Yes

If yes, how long?

For which event(s) are you interested in volunteering/interning? (Please check all that apply.)

Administrative Tasks (receptionist/ mailings, etc.) - As needed, throughout the year (temporarily unavailable due to COVID-19)

BOO-jolais Wine Celebration - Friday, October 29, 2021 (tentative due to COVID-19)

Columbia~Greene Garden Party - Saturday, September 4, 2021 (tentative due to COVID-19)

Holiday Gift Wrap - November 26 - December 24, 2021 (tentative due to COVID-19)

Masks for COVID-19 Response - Ongoing (urgent!)

Virtual Dining Out For Life® - Thursday, June 10, 2021

Personal/Professional Reference *

Reference Phone Number *

By checking this box, I am certifying that I have read and understood this form. I affirm that the information provided on this form is true and complete to the best of my knowledge. I understand that completion of this registration form does not imply acceptance in to the Alliance for Positive Health volunteer program. If accepted, I agree to abide by all rules, policies and procedures as set forth by the Alliance for Positive Health. I also understand that there will be specific requirements to which I must adhere, including maintaining confidentiality of clients for each volunteer assignment. Age restrictions may apply. *

I understand & agree

Your #dreamjob could be just a click away! The Alliance for Positive Health is currently hiring for multiple positi… View Tweet
This morning, members of our Albany team loaded up their cars to deliver over 2,300 pounds of food to our Hudson of… View Tweet
The Alliance for Positive Health's Food4Life program provides #NutritionEducation for those living with HIV/AIDS. C… View Tweet

Volunteer

Alliance for Positive Health

Quick Links

CORPORATE SPONSOR:

SAVE THE DATE!

Support Alliance for Positive Health

Subscribe to Newsletters

Twitter

Contact Us