Erie County Volunteer Registration

Welcome to Erie County's Volunteer Program!

Please fill out the application below to join.

Current turnaround time after your application is submitted is 5 business days. Once processed, you will be contacted by a staff member at the phone number you provided to schedule your required New Member Orientation.

Basic Information

First

Last

Address

City/Town

State/Province

ZIP/Postal Code

Main Phone Number

Confirm email

Date of Birth

Are you a US Veteran?

Yes

Are you retired?

Yes

Previous/Current Occupation?

Are you currently volunteering?

Yes

Where are you volunteering?

Transportation Information

Will you be driving to your volunteer assignment?

Yes

Members have the option for mileage reimbursement (Currently $0.14/mile with a quarterly max of $56. This is subject to change) Will you be requesting mileage reimbursement?

Yes

Your SSN is required to receive any travel reimbursement from Erie County's Volunteer Program. Please enter it below if you are requesting reimbursement.

To receive mileage reimbursement and to be covered by the supplemental automobile insurance policy provided by Erie County's Volunteer Program, please enter the information below.

Drivers License ID Number (9 Digits)

Driver's License - State and Expiration Date

Name of Insurance Company

Insurance Policy Number

Emergency Contact Information

First

Last

Relationship

Emergency Contact Phone Number

Photo Release

Have you ever been convicted of a felony?

Yes

Have you ever been convicted of child sexual abuse?

Yes

I agree to undergo a National Service Criminal History Check, including the National Sex Offender Registry Database. Volunteer stations may require an additional background check. I understand that I may be disqualified for the following: murder conviction, registered on the Sex Offender Registry, refusal to undergo the National Service Criminal History Check and any false statement about my criminal history.
I agree that if I use my personal vehicle to travel to and from my volunteer assignment and/or to carry out my volunteer work, I will maintain a valid driver's license and auto insurance.
I understand the information on this form will be kept confidential.