Volunteer Application

Medical Professional Information

License Type * Please select license type

License State * Please enter license state

License Number * Please enter license number

License Expiration Date * Please enter expiration date

NPI Number National Provider Identifier (if applicable)

CPR/BLS Certification * Please select

Outreach & Field Experience

Experience working with diverse communities

Are you comfortable working outdoors? * Please select

Community Health Worker Information

CHW focus areas

Community Health Worker (CHW)

Asthma Preventive (AP)

Justice-Involved (JI)

Are you a certified CHW? * Please select

Experience working directly with communities to promote health and wellness * Please describe your experience

Experience with health education and outreach

Training in evidence-based health education models (e.g., Diabetes Prevention Program)

Technical Experience

Technical tools/platforms you're comfortable with

Relevant certifications

GitHub or portfolio link

Board Member Application

Title / Profession

Company / Organization

Work email

Work phone

Current and past Board experience

Current associations and/or club affiliations

Skills and expertise * Please describe your skills and expertise

Educational background

Greatest strengths and growth areas

What do you feel is essential for Board and staff to be successful?

Experiences, expertise, connections, or resources you would bring

Interest in joining this Board

What type of Board tasks do you prefer?

Project ideas

Fundraising experience

Standing committees you're interested in

Board Building & Governance

Development

Finance & Human Resources

Program

Time you can dedicate to Board service

Board commitment *

Our Board is a working Board. Members participate in quarterly Board meetings, standing committee meetings (typically monthly), and fundraising/development activities, including an annual personally meaningful gift. Board terms are a minimum of one year.

Please indicate if you can make this commitment

Community Advisory Board Application

What do you think will be your major or general contribution to the Community Advisory Board (CAB)? * Please describe your contribution

Short summary of your background, skills, and expertise of value to the CAB * Please share your background

Why are you interested in serving on the Community Advisory Board? * Please share your interest

Skills, experiences, or resources you would bring to the CAB

Social Media Experience

Tell us about your previous experience in social media marketing * Please describe your experience

Which social media platforms are you most familiar with? * Please list platforms you're familiar with

How would you create a social media strategy for our brand? * Please describe your strategy approach

Share some of your most notable social media achievements

How would you generate leads or sign-ups using social media?

Describe a time you adapted a campaign based on analytics or feedback

Grant Writing Experience

How long have you been writing grants?

Areas of expertise (issue areas, populations, or funder types) * Please share your areas of expertise

Tell us about a grant you wrote that was funded * Please describe at least one funded grant

How do you research and identify grant opportunities?

How do you handle the review and submission process?

How do you communicate with team members to get information you need?

Describe a challenging grant proposal you worked on and how you overcame difficulties

What persuasive techniques do you use in your writing?

How do you ensure all details are captured in an RFP?

Events Coordination Experience

Describe your experience in event planning and the types of events you've managed * Please describe your event planning experience

What is the largest event you've organized?

How do you find reputable vendors and build relationships with them?

How do you negotiate with third parties like vendors and sponsors?

Content Writing Sample

Attach a writing sample * A short article, blog post, or social copy you’ve written. Max 10MB. Please attach a writing sample

Volunteer Application

Let's Get Started

Where Are You Located?

Your Availability

Your Role & Documents

Medical Professional Information

Outreach & Field Experience

Community Health Worker Information

Technical Experience

Board Member Application

Community Advisory Board Application

Grant Writing Experience

Events Coordination Experience

Content Writing Sample

Required Documents

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