Iowa Donor Network

Volunteer Contact Information

First Name *

Last Name *

Email Address *

Address *

City *

State *

Zip *

Country

County *

Home Phone Number *

Okay to Call Me Here

Work Phone Number

Cell Phone Number *

Date of Birth

Gender *
Male Female

Are You a Registered Donor? *

Education / Employment

T-Shirt Size

School/College (if currently enrolled)

Occupation

Employer

Foreign Languages Spoken

Your Connection to Donation

Your Connection to Donation *

Volunteer Background Information

Volunteer Biography

I am interested in the following Volunteer Outreach Opportunities:

Public Speaking (Community/Driver’s Education, Sharing your personal story)

Tabling Events (Donor Registration Drives, Health Fairs, Hospital Events, etc.)

Special Events (IDN sponsored events, annual donation awareness events, etc.)

Office Support (Organize supplies, data entry, prepare mailings, etc.)

Virtual Support (Social media, phone calls, etc.)

What skills and/or hobbies do you have that can contribute to your volunteer efforts?

Personal Background Information

How did you learn about Iowa Donor Network’s volunteer program?

Have you ever been convicted of a crime or violation, other than a minor traffic violation? Are there criminal charges now pending against you other than a minor traffic violation?
(A conviction record will not necessarily bar team membership. Factors such as age of the offense, seriousness and nature of the violation, and rehabilitation will be taken into account.)

Have you ever been terminated from a volunteer position?

Emergency Contact Info

Contact Name

Relation to Contact

Emergency Contact Email

Contact Phone

Contact Alternate Phone

Volunteer Agreement

I understand that the following are expectations of the Iowa Donor Network Volunteer Program:

I certify that the information provided in this application is true and correct in all respects without any willful omissions.
I understand that I may be screened at Iowa Donor Network’s cost for a background investigation. The investigation shall include, but is not limited to: Motor Vehicle Records Check, Social Security Trace, Child Abuse Registry Check, Criminal History Check, Education Verification and/or employment verifications. A positive finding for any of the above, such as a conviction or court-imposed penalty for a crime, may preclude me from consideration as a volunteer.
I will demonstrate a courteous, knowledgeable and professional manner in all interactions in my role as an Iowa Donor Network volunteer.
I will complete the necessary training required for my volunteer role and keep current with Iowa Donor Network communications and information for volunteers.
I agree that as an Iowa Donor Network volunteer, I am responsible for maintaining the confidentiality of all proprietary or privileged information to which I am exposed.
I am advised that failure to comply with these policies may result in disciplinary action which could include release as an Iowa Donor Network volunteer.

I have read the above statement and understand and agree to its contents.

First and Last Name *

Volunteer Application

Volunteer Contact Information

Education / Employment

Your Connection to Donation

Volunteer Background Information

Personal Background Information

Emergency Contact Info

Volunteer Agreement

Our Vision:

Understanding Donation

Donor Families

Professional Partners

Transplant Recipients

Volunteer Application

Volunteer Contact Information

Education / Employment

Your Connection to Donation

Volunteer Background Information

Personal Background Information

Emergency Contact Info

Volunteer Agreement

Our Vision: