What's your email address?

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.
First name *
Last name *
Date of Birth *

A valid date as MM/DD/YYYY (for example: 11/30/2015)
Are you at least 18 years of age?

Phone Number *

For example, 123-456-7890
SMS (text) messaging:
You may opt-in to receive SMS (text) for JPH Organization 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.
Street Address
Town
Emergency Contact
Emergency Contact Phone Number
When are you available to volunteer?











Do you have previous experience working as a volunteer for an organization?
Do you have professional or personal experience that could be helpful to JPH? If yes, please describe.
Indicate all areas if volunteering that interest you:













If you are interested in being part of the Reiki team, please indicate level of certification