I Want to Be a Buddy...

You get it! Investing in others brings great reward. Let's get started...

Complete the information below. Applications are limited to 20 volunteers. Once the selection process is complete, you will receive additional information regarding next steps. Upcoming groups will be made known to those who have completed this process.

Contact us with any questions at info@freedomplaceinc.com.

Name

First Name

Last Name

Email Address

Date of Birth

MM

DD

YYYY

Contact Number

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Occupation

Emergency Contact

First Name

Last Name

(###)

###

####

Do you have any physical limitations?

*Physical limitations will not prohibit participation as a buddy.

Have you ever been arrested or convicted of a crime?

If yes, explain.

Briefly describe why you want to volunteer.

Do you work closely with child welfare services? If so, how?

Reference 1

First Name

Last Name

Ref 1 Phone

(###)

###

####

Ref 1 Email

Reference 2

First Name

Last Name

Ref 2 Phone

(###)

###

####

Ref 2 Email

Thank you!

We look forward to a great group together!