| Salutation |
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| First Name * |
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| Last Name * |
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| Address |
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| City |
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| State * |
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| Zip Code |
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| Country |
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| Phone Number |
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| Email Address * |
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| Age* |
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| Some volunteer positions may require applicants be over 18 or over 21 years of age. |
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| I would like to volunteer at* |
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| Preferred Volunteer and/or Intern Positions (please rank your choices): |
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National Eating Disorders Association Hours of Operation: 8:30am-4:30pm, Mon.- Fri. PST
Please indicate your time availability and preferences: |
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| Preferred number of hours per week: * |
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| Preferred number of hours per month: * |
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| Available start date? * |
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| What is your highest level of education/degree obtained? |
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| I grant the National Eating Disorders Association the right to contact the following reference: |
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| Reference Name |
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| Reference Phone |
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| Reference Relation |
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| Emergency Contact |
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| Name |
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| Phone |
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| Relation |
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| Describe any specialized training, apprenticeship, skills, volunteer experience, or hobbies as they pertain to the volunteer opportunity: |
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| Please share your thoughts concerning any expectationsor ideas for your volunteer experience, what you feel are your greatest assets you bring to being a NEDA volunteer, or your personal feelings regarding eating disorders and body image: |
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| APPLICANT'S STATEMENT |
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I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application at the discretion of the National Eating Disorders Association.
I understand that false or misleading information given in my application or interview(s) may result in dismissal as a volunteer. I understand, also, that I am required to abide by all rules and regulations of the National Eating Disorders Association.
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