Volunteer Application Form

Please complete each section below. All required fields are highlighted.

* First name

* Family/Last Name

Gender

* DOB

* Address

* City

* State

* Zip code

* Primary Phone (Cell, Home or Work)

* E-mail

As a registered Special Olympics Pennsylvania (SOPA) volunteer, you will receive occasional email communications about our activities, promote inclusion, raise awareness, or garner support for our mission. We do not share your personal information with third parties.

In case of emergency, who should we contact?

* Contact name

* Relationship

* Primary Phone (Cell, Home or Work)

Race/Ethnicity

Language

Disability

How Did You Hear About Us?

* Other Please (Specify)

* Employer/School

Volunteer Classifications

Special Olympics Pennsylvania has two different classifications of volunteers. They are:

Class A: Class A Volunteers have immediate contact with athletes such as coaching or assisting with team practices or competitions. Because of this, Class A Volunteers are required to complete a background check before beginning to volunteer. Additional online trainings are also required. After submission of this form, you will receive an email to complete the required background checks.

Class B: Class B Volunteers have casual or limited contact with athletes such as assisting with one-day or special events. After submission of this form, you will be automatically directed to a listing of upcoming volunteer opportunities.

Please select your Volunteer Classification.

As required by PA law and in accordance with Special Olympics Pennsylvania policy, you will need to complete background checks in order to become or remain a Class A volunteer.

Please Note: Class A volunteers that are 17 years of age and under do not need to complete background checks.

Step #1: Print, complete the PA Disclosure Statement and upload. You must obtain a "witness" signature. A witness is someone who is 18 years of age or older and can attest to your signature. Your signature and your witness signature must be handwritten; no electronic signatures will be accepted. To upload, "Browse" for a file, select and "Submit."

If you have not lived in PA for the past 10 consecutive years, an FBI Fingerprint Criminal History Record is required by law. Click here to find locations to support this requirement.

Please select the role you would like to Volunteer for.

Class B

Health Information

Health information is collected in case of emergency. Each participant is responsible for determining if the participant is physically able to participate.

Please mark if you have any of the following conditions and provide details:

Special Dietary Needs

* Enter Details

Allergies

* Enter Details

Assistive or Implantable Device

* Enter Details

High Blood Pressure

* Enter Details

Heart Condition

* Enter Details

Asthma or Respiratory Condition

* Enter Details

Mental Health Condition

* Enter Details

Epiliepsy or Seizure Disorder

* Enter Details

Neurological Condition

* Enter Details

Diabetes

* Enter Details

Sickle Cell Anemia/Trail

* Enter Details

Chronic Infection

* Enter Details

Missing Organ (e.g., spleed, kidney)

* Enter Details

Other Health Conditions

* Enter Details

Please select Yes or No and list any medications, vitamins, or dietary supplements below:

Medication Name 1

Dosage 1

Times Per Day 1

YES/NO to add another Medication 2

Medication Name 2

Dosage 2

Times Per Day 2

YES/NO to add another Medication 3

Medication Name 3

Dosage 3

Times Per Day 3

YES/NO to add another Medication 4

Medication Name 4

Dosage 4

Times Per Day 4

YES/NO to add another Medication 5

Medication Name 5

Dosage 5

Times Per Day 5

YES/NO to add another Medication 6

Medication Name 6

Times Per Day 6

Dosage 6

YES/NO to add another Medication 7

Medication Name 7

Dosage 7

Times Per Day 7

YES/NO to add another Medication 8

Medication Name 8

Dosage 8

Times Per Day 8

YES/NO to add another Medication 9

Medication Name 9

Dosage 9

Times Per Day 9

YES/NO to add another Medication 10

Medication Name 10

Dosage 10

Times Per Day 10

What Local Program (select) should we notify of your volunteer interest?

Please reconfirm your selection.

Background

As a volunteer for Special Olympics Pennsylvania, we are required to gather some further background information on you. Any "Yes" responses will require that our office directly contact you before continuing.

Do you use illegal drugs?

Have you ever been convicted of a criminal offense in Pennsylvania or any other state?

Have you ever been charged with and/or convicted of neglect, abuse or assault?

Has your driver's license ever been suspended or revoked in any state?

* If you answered 'Yes' to any of the questions above, please provide an explanation here.

Policy Acknowledgement

Please open and review the following Special Olympics Pennsylvania (SOPA) policies. By submitting this volunteer application, you are attesting that you have read, understand and agree to uphold.

Click Here for Code of Conduct

* I have read, understand and agree to uphold SOPA's Code of Conduct.

Click Here for the SOPA Housing Policy

* I have read, understand and agree to uphold SOPA's Housing Policy.

Acknowledgment of Risk

I understand I could get Coronavirus through in-person sports, training, competition and/or any group activity at Special Olympics Pennsylvania. I am choosing to participate in sports, training, competition and/or other Special Olympics Pennsylvania activities at my own risk.

Volunteer - 17 and under

Volunteers who are 17 and under will recieve an email with a "17 and under application" that must be signed by a parent/guardian. If this procedure is not followed, the individual will not be eligible to volunteer for Special Olympics Pennsylvania. Upon the individual's 18th birthday the Special Olympics Pennsylvania background check process must be followed depending on the volunteer classification. Volunteers minor may not be alone with any participating Special Olympics athlete during the course of their duties as a volunteer with SOPA and its programs and/or events.

Volunteer Signature

By signing/submitting the volunteer application, I affirm that I have read, understand and will adhere to the responsibilities and code of conduct; and that the information I have given is true and complete. If at any time the information provided is found to have been knowingly falsified, I will be disallowed from volunteering with Special Olympics Pennsylvania.

* E-Signature for all applicants