Make an Impact

Volunteer Application

Use the form below and Give Back Wisconsin will contact you!

Contact Information
Name *
Your Address *
Your Address
Phone *
Additional Phone
Additional Phone
During which hours are you available for volunteer assignments? *
Check all that apply.
Tell us in which areas you are interested in volunteering. *
Please check all that apply.
Special Skills or Qualifications
Previous Volunteer Experience
Person to Notify in Case of Emergency
Name 1 *
Name 1
Address 1 *
Address 1
Phone *
Additional Phone
Additional Phone
Agreement and Signature
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.
Name (Signature) *
Name (Signature)
Today's Date *
Today's Date
Our Policy
It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability. Thank you for completing this application form and for your interest in volunteering with us. Please submit questions to