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Volunteer Application

ACCESS AIDS Care is open to any individual that qualifies for HIV/AIDS services and support in Hampton Roads. If you would like to volunteer with us, please provide us with the following information.

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* Required information.
Title *
Name *
Nickname
Street Address
City
State
Zip
Home Phone
Cell Phone
Work Phone
Email *
DOB (MM-DD-YYYY) *
Prior Volunteer Experience
Employer
Occupation
Emergency Contact Name
Emergency Contact Phone
Emergency Contact Relationship
Education Level
How did you hear about us?
Do you have your own transportation?
Do you have a valid Drivers' License?
What days are you available?
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
What programs are you interested in volunteering with?
Administrative
Childrens Services
Bingo
Meals Program
Outreach Activities
Holiday Events
Summer Festevents
Special Events
The LGBT Center

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2. Click on Donate
3. Submit your Donation!
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Contact ACCESS

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ACCESS AIDS CARE  |  757-640-0929
This site contains HIV prevention messages that might not be appropriate for all audiences. Since HIV infection is spread primarily through sexual practices or by sharing needles, prevention messages and programs may address these topics. If you are not seeking such information or may be offended by such materials, please exit this website.
User Agreement
© 2009 - ACCESS AIDS CARE