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Volunteer Information
First Name Last Name
Birthday Address
City State
Zip Home Phone
Cell Phone Email
School Religion
Grade Gender Male Female
Parent Contact Information
Mother's Name Father's Name
Mother's Email Father's Email
Mother's Cell Father's Cell
Mother's Occupation Father's Occupation
Religious Affiliation Parents' Marital Status
Additional Information
When would you like to volunteer at the home of a child with special needs?
First Choice: Day of the Week Time
Second Choice: Day of the Week Time
Do you have a friend with whom you would like to volunteer
Friend's Name Phone Number
Where did you hear about Friendship Circle
Are your parents available to drive you to or from the child's home? (to)
Please list one reference who is not a relative. (For New FC Volunteers Only)
Name Relationship
Medical Information
In case of an emergency, when neither parent can be reached, please provide the name of someone who will take responsibility for your teen
Name Relation
In case of medical emergency requiring immediate emergency care, I authorize the paramedics to take my child to the nearest hospital if necessary
Health Insurance Name Number
Medical Concerns
Volunteer Agreement
In the event that I am unable to volunteer I will try to find another day to substitute and I will call my special friend in advance
I will send in a report after every time I volunteer
In the event of a volunteer function I will try my hardest to attend however, regardless, I will always respond.
Parental Consent
I give my teen permission to volunteer in the Friendship Circle
I give permission for my teen's photo/s to be used for publicity purposes.
I (Parent of the Volunteer), would be interested in assisting the Friendship Circle at future events
What Programs Interest You?
Sunday Circle- Join us for 2 hours of fun and entertainment with a young child with special needs. At each Sunday Circle, you will join your buddy in an art class, play time and music.

NOTE: Punctuality and commitment are very important!

Friends @ Home - Volunteers get together with their special needs buddy in the child's home for 1.5 hrs. every week. This program provides the opportunity for teens to get to know their friend with special needs on a more personal level and build a relationship that last forever!
Winter/Summer Camp - Join us for an experience that will last a lifetime! At the FC Winter/Summer Camps you will transform your vacation as well as the vacation of a child with special needs into an exciting camp experience with fun-filled activities, games, sports and field trips.

Commitment: 5.5 hrs. each day for one week per camp.

Young Adult Circle- Join us for 2 hours of fun at Young Adult Circle, where you and your buddy will learn life skills useful for an everyday basis! Our program includes everyday activities, social skills, cooking, shopping, adventures and entertainment, which simultaneously incorporate independence, laughter, and friendship that make for great memories.
Basketball Buddies - Basketball buddies is a way that the volunteers and kids can be with each other while playing a sport they love. This program allows for the kids to be part of a team, and to learn the fundamentals of Basketball.
Hangin' With Friends - This program is for adults with special needs and volunteers 15+. This program will offer entertainment and fun activities that are more age appropriate for our young adults and provide them with even more opportunities to make new memories with their friends.

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