Please fill out the following application to be considered for an Open Door Care Network Volunteer position.  

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Your information


Required fields are marked with an asterisk (*). One of the fields below is a file upload/attachment, the file size must be less than 10MB.
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A valid date as MM/DD/YYYY (for example: 11/30/2015)
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For example, 123-456-7890
SMS (text) messaging:
You may opt-in to receive SMS (text) for Open Door Care Network volunteer activities, including shift reminders and cancellations.

To opt-out, reply STOP to any SMS message OR update the SMS opt-in setting in your profile.
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A valid date as MM/DD/YYYY (for example: 11/30/2015)
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Languages Spoken *


























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Interests *






Volunteer Location Site






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VOLUNTEER MEDIA RELEASE
I hereby give my consent to all photographs, audio recordings, and/or video recordings taken of me, my minor child/children, or children for whom I am the legal guardian of, by Open Door Care Network (Open Door) staff or their designee. I understand that any such photographs, audio recordings, and/or video recordings become the property of Open Door Care Network for the purpose of promoting their organization in brochures, print, radio, print media, social media, and television media. There is no limit to how these images can be used for the publicity and promotion of Open Door.

I waive any and all rights that I may have against Open Door, any employee or representative of Open Door for the use of my picture or audio recording in the advertising and promotion of Open Door services, including any claims for damages or payment in connection with their use.

I understand that once my image has been printed or used in the development of a media campaign, that I cannot rescind consent. I can, however, rescind consent for the use in future media campaigns.
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Open Door is proud of the local and national recognition it has received:

This health center receives HHS funding and has Federal Public Health Service (PHS) deemed status with respect to certain health or health-related claims, including malpractice claims, for itself and its covered individuals. In accordance with Federal law and U.S Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, age, disability, religion, sex, and familiar status. (Not all prohibited bases apply to all programs). To file a complaint of discrimination, write UDSA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410 or call (800) 795-3272 (voice) or (202) 720-6382 (TDD).