Volunteer Application

The Compeer program provides friends for individuals referred by mental health professionals. The answers to the following questions enable the Compeer staff to match you with an appropriate person who will benefit from your friendship. Compeer does not discriminate based on race, creed, color, religion, gender, age, national origin, marital or veteran status or sexual orientation. Compeer is aware of the sensitive nature of some of the questions asked on the application form and during the interview process. It has been our experience that having as much information as possible about each individual, whether volunteer or referred client, increases our ability to match people successfully. All information is requested to ensure, to the greatest degree possible, the success of the matching process. If you have any questions about any part of this application please contact the Volunteer Coordinator.

Contact Information

First Name *This question is required.

Last Name *This question is required.

Date of Birth *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

My gender is *This question is required.

Street Address *This question is required.

Apt/Suite

City *This question is required.

Zip *This question is required.

Email Address *This question is required. This question requires a valid email address.

Primary Phone Number *This question is required. Please provide a 10-digit phone number including area code.
Enter numbers only. Formatting such as dashes will be added as you enter your phone number.

Secondary Phone Number

When can we best reach you? *This question is required.

Are you a student? *This question is required.

Is your email different when you are not in school? *This question is required.

E-mail When Not in School: *This question is required. This question requires a valid email address.

Is your phone number different when you are not in school? *This question is required.

Phone When Not in School: *This question is required.

Have you lived at your current address for at least 10 years? *This question is required.