Volunteer Information

VOLUNTEER ENROLLMENT FORM

California Institution for Women (CIW)

- Victim Impact -

June 23, 2024 (One Accord Meeting)

June 23, 2024 (Workshop)

* Required Fields

Contact Information

NOTE: If you are experiencing technical difficulties, please use a computer or tablet.

First Name

Last Name

Email (Please use your own email address)

Address

Address 2

City

State/Province

Zip/Postal Code

Cell Phone

Home Phone

Work Phone

Volunteer Information

Please share your intention for participation

Previous FTC volunteer?

Do you have prior experience doing trios (not sure, please select "No")?

How did you learn about us? If a person, please provide name of individual. (Veteran Volunteers, please type n/a)

Name Tag (first name or nickname only)

Backup Angel - If the volunteer team is full, I can join the team with minimal notice

Do you have metal in your body?

Ex: Pin in ankle, etc. (if so, please bring a doctor's note.)
Note: Fillings in teeth don't matter

Do you have any physical needs that require special arrangements?

If yes, please explain

Any Questions or Comments

My photo ID (e.g. Driver's License) that I will bring to the prison
is valid and the information has been submitted to FTC.
If we do not yet have your clearance information, please copy and paste this link:
http://weblink.donorperfect.com/SecurityClearance

Proficient in any languages other than english?

Spanish

Enter any others:

Emergency Contact Information

If you are new to the project OR
if your contact info has changed,
please fill in this section

Name of your emergency contact person
Someone who is not a volunteer on the project

Their relationship to you

Their cell phone #

Their alternate phone #
(Ex: work, home)

If you are new to the project OR if your contact info has changed, please fill in this section

If you are new to the project OR
if your contact info has changed,
please fill in this section