Volunteer with us - South Carolina Autism Society

Name *

First

Last

Phone *

Phone Type

Cell
Home
Business

Email *

Address *

Address Line 1

City

State

Zip Code

Driver's License #

State

Emergency Contact *

Relationship

Emergency Contact Phone #

Volunteer Interest and Experience

Do you hold any certifications or licenses related to Social Work?

Yes
No

Please describe briefly your reason for volunteering with SCAS

Please list any experience that you think would relate to the work of the South Carolina Autism Society:

Areas of Interest (check all that apply)

When are you available? *

How much time can you dedicate to volunteering in a week? *

Are you able to travel within the state in volunteering with SCAS?

Yes
No

Regional area or mileage able to travel:

Please note:

We require a background check to work clients and the public. Additional paperwork will be provided to complete checks. Some training may be required for specific volunteer duties.

I certify that the above information is truthful to the best of my knowledge. *

Clear Signature

Signature of above named volunteer