Volunteer Application

Thank you for your interest in volunteering at the Clinic for Special Children!

To be considered for a volunteer opportunity, please fill out the below application. A Clinic for Special Children staff member will review your application and will be in touch with you.

IF YOU NEED FURTHER ASSISTANCE: Please email us at queries@clinicforspecialchildren.org.

Volunteer Application

Date
MM slash DD slash YYYY
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email
Preferred Contact Method
- Phone
- Email
Do you know anyone who has received care at the Clinic for Special Children?
Which of the following activities interest you?
- Event Assistance (5k, auctions, family days)
- Administrative Support (mailings, data entry, filing)
- Facility Care (landscaping, cleaning)
- Staff Training/Development (lunch-n-learns, team building, wellness)
- Communications/Development (social media, phone calls, flyer distribution)
- Clinical (vitals, blood draws, vaccinations, phone calls)
- Other
Please mark all that apply.
If you selected 'other' for activity interest, please describe below:
How often would you like to volunteer?

Weekly, monthly, as needed, etc.
What is your preferred method/availability?

Remote, in-person, weekdays/weekends, days/evenings, etc. Please be as specific as possible.
What is your educational background/work or volunteer experience?
How did you hear about the Clinic for Special Children?
What interests you the most about volunteering at the Clinic for Special Children?
CV/Resume
Max. file size: 128 MB.
Optional

Required Paperwork to Email Us

To become a volunteer, the following background clearances are required (acceptable within the last 5 yrs). Review and approval of volunteer applications submitted without clearances may be delayed. Please the applicable paperwork to queries@clinicforspecialchildren.org:

Licenses and Certifications

PA State Police Criminal Record Check
1. https://epatch.pa.gov
2. Electronic submission online at web site
3. Fee for VOLUNTEERS is $0 (zero)
PA Child Abuse History Clearance
1. https://www.compass.state.pa.us/cwis/public/home
2. Electronic submission online at website – PA CWIS/Child Welfare Portal
3. Fee for VOLUNTEERS is $0 (zero)

If you have an active license to practice in PA, please also submit your license to us in your email.

FBI Fingerprint OR Disclosure Statement Application for Volunteers

We also require the results of your FBI Fingerprint Clearance OR a completed Disclosure Statement Application for Volunteers. Please email us FBI Fingerprint Clearance results OR your completed Disclosure Statement. If you have not lived in PA in the past 10 consecutive years, the FBI Fingerprint Clearance is necessary. Review and approval of volunteer applications submitted without clearances may be delayed.

FBI Fingerprint Clearance
1. https://www.identogo.com/
2. Enter Service Code: 1KG6ZJ for volunteer
3. Schedule fingerprint appointment – prior to going to the fingerprint site
4. Applicant proceeds to the fingerprint site listed on IdentoGO website
5. $25.25 fee paid at fingerprint site (fee may vary)
  
  OR

Disclosure Statement Application for Volunteers
1. To download the form to fill out, please visit https://bit.ly/46hq7ZY