Alzheimer's OC Volunteer Application

Sign up to volunteer at Alzheimer's Orange County! If applying for an internship, please return to the Volunteer/Intern page, scroll to the end of the page to read about our available Internships and to complete the Internship Application.

First Name *

Last Name *

Phone *

Email *

Birth Date

// (mm/dd/yyyy)

Address 1

Address 2

City

State

Zip

Have you volunteered with us before? *

Yes
No

No minor is allowed to participate in an Alzheimer's Orange County project or activity without a parent/guardian signed release form.

I understand this policy.

Which volunteer position are you interested in receiving more information? *

Dementia Friends Champion
Events Volunteer
Memory Support Helpline Volunteer
Support Group Facilitator
Connect2Culture Volunteer

How many days a month are you able to volunteer? *

How many hours a week are you able to volunteer? *

Which days are you available to volunteer? (Select all that apply) *

Monday
Tuesday
Wednesday
Thursday
Friday

What shifts are you available to work? (Select all that apply) *

Morning
Afternoon
Evening

Tell us a bit about yourself...

Some AlzOC volunteer roles will require you to complete HIPAA training and submit a LiveScan background check. By checking the box below, you agree to these terms. *

Yes, I agree

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Alzheimer's OC Volunteer Application