Join BXVC : Individual Application

Form for applying as an individual.
Name *
FirstLast
Please provide us with your name.
Create a Username *
0 of 20 max characters
This will be your identity on BXVC.org
Password *
Create PasswordConfirm Password
Date of Birth *
I certify that I am 18 years of age or older. *
Yes
No
If not 18, I certify that I’ve received permission from a parent/guardian to apply for a volunteer opportunity through the Bronx Volunteer Coalition
I certify that I’ve received permission from a parent/guardian to submit this application
Please provide name and contact info for your parent or legal guardian.
FirstLast
Guardian Email
Guardian Phone
Gender
Male
Female
Other
Email *
Enter EmailConfirm Email
Please supply the best email address to reach you to setup your account.
Preferred Phone #
What's the best phone number to reach you?
Group Opportunities
I am applying on behalf of a group
Name of Group
In which Bronx neighborhood would you like to volunteer?
Please select two additional Bronx neighborhoods in which you would like to volunteer.
 
What neighborhood do you live in?
Address
Street Address
Address Line 2
CityState
ZIP Code
What time of day are you available to volunteer? *
Morning
Afternoon
Evening
When are you available to volunteer? *
Weekdays
Weekends
What type of volunteer opportunities are you looking for?
One-time volunteer opportunities
Short-term volunteer opportunities (under 6 months)
Long-term volunteer opportunities (over 6 months)
Do you have a particular skill set you would like to use?
0 of 450 max characters
Tell us about your talents.
Do you have a particular area of interest?
Animals
Arts/Culture
Children/Youth
Disaster
Education
Environment
Hunger/Health/Nutrition
Mentoring
Poverty/Urban Development
Seniors
Women
Other