Get Shiip Volunteer Registration Form

Filling out the SHIIP Volunteer Registration Form online is a straightforward process designed to gather essential information for potential volunteers. This guide provides step-by-step instructions to assist you in completing the form accurately and efficiently.

Follow the steps to successfully complete the SHIIP Volunteer Registration Form online.

1. Click ‘Get Form’ button to access the SHIIP Volunteer Registration Form and open it in your preferred editor or browser.
2. Begin by entering your name in the designated fields for first, middle initial, and last name.
3. If applicable, include your business or agency name in the following section.
4. Provide your mailing address in the corresponding field, ensuring that all components are correctly filled out.
5. If your shipping or physical address differs from the mailing address, input it in the specified field.
6. Fill in the city and zip code associated with your mailing address.
7. Indicate your county of residence in the provided section.
8. List your telephone numbers including home, work (with extension if applicable), and cell numbers.
9. Enter your email address and confirm whether you have high-speed internet access.
10. Answer the question about whether you or any immediate family members are licensed insurance agents, providing details if applicable.
11. Respond to the inquiry regarding any past convictions beyond minor traffic violations and provide explanations if necessary.
12. List three references, including their names, relationship to you, and contact information.
13. If you can provide counseling and/or outreach in additional counties, indicate them in the appropriate space.
14. Select whether you are a Medicare beneficiary and complete the gender and disability-related fields.
15. Provide your date of birth in the designated section.
16. Select your ethnicity from the provided list.
17. Indicate the highest level of education you have achieved by checking the relevant box.
18. Choose your preferred types of SHIIP Volunteer Counselor activities by checking all applicable options.
19. Detail any other volunteer services you are involved with, if any.
20. Outline any skills you possess that could enhance your role as a SHIIP volunteer counselor.
21. Mention any interests or hobbies that may benefit the SHIIP program.
22. List the languages you speak by checking all that apply.
23. In the acknowledgment of volunteer’s relationship section, sign your name and provide your county and date.
24. After completing all fields, ensure that your form is saved appropriately. You can then choose to download, print, or share the finalized document.

Complete your SHIIP Volunteer Registration Form online today and contribute to your community!