Thank you for your interest in volunteering with The Single Mom KC.

There is no way we can walk alongside single mother families without Volunteers like you!

Please Scroll down to fill out and submit the following information so we can better connect you with Volunteer opportunities. 

Our Volunteer site requires all Volunteers have an email address. 

If  you share an email with another Volunteer please contact me for assistance. 

If you need help with this form or have questions please feel free to contact me.

Thank you!

Michelle Hartegan
VOLUNTEER COORDINATOR
michelle@thesinglemomkc.org
913.359.0791

What is your email address?

Your information


Required fields are marked with an asterisk (*).
First Name *
Preferred Name
Last Name *
Phone Number *

For example, 123-456-7890
SMS/text messaging: By providing your mobile number and checking the box below, The Single Mom KC will be allowed to send you SMS (text) messages relating to their volunteer activities. To opt-out, reply STOP to any SMS message OR return to this form and uncheck the box.
Street Address *
Street Address (line 2)
City *
State *
Postal/Zip Code *
County *
Date of Birth *

A valid date as MM/DD/YYYY (for example: 11/30/2015)
Emergency Contact Name *
Emergency Contact Phone Number *
Medical Conditions or Allergies
I identify my race/ethnicity as (please select all that apply)






Languages Spoken


List languages spoken (other than English and Spanish).
Is there a protective order prohibiting someone to have contact with you? If YES, the Executive Director or Program Director will follow up with you. *
Employer
Are you volunteering in order to earn community service hours?
If Yes, what is the name of the organization?
Contact Person
Contact Phone
Volunteer Interests: Choose all areas you are interested in volunteering. *











How did you learn about The Single Mom KC? *
Church Name
Name of Agency or Organization
Who referred you?
Is there anything else you would like us to know about you?
Waiver: Social Media, Photographic Images and Video Release Form
Photographic images and/or video might be recorded during events or activities hosted by The Single Mom KC.
By signing this agreement you grant permission for images of yourself to be used for publicity or marketing for
The Single Mom KC or posted on The Single Mom KC social media sites.
As a volunteer for The Single Mom KC, do you acknowledge that you have read, understand and agree to be bound by the above statements? *

IF YES, ENTER YOUR NAME HERE TO SERVE AS A DIGITAL SIGNATURE:

Code of Conduct

Liability Release & Volunteer Guidelines
By signing this agreement you indicate that you understand the responsibilities involved with being a volunteer at any
The Single MOM KC event or Clothed with Dignity Boutique and that you are willing to the best of your ability to honor the
responsibilities to which you commit.
1. The Single MOM KC is not responsible for injuries that you may suffer while volunteering in any capacity.
2. Volunteers understand that they may refuse to participate in any activity for any reason.
3. All The Single MOM KC facilities are smoke-free.
4. Since volunteers represent The Single MOM KC at all events and serving in the Clothed with Dignity Boutique, you are
asked to behave in a way that corresponds with the Christian values and mission statement of The Single MOM KC.
5. No photo images can be taken of any child.
Client Confidentiality Policy
Any information that we may have access to must be treated as strictly confidential. Absolutely no information about our clients,
other than that which is specifically noted as public knowledge, should be shared with any other person. Failure to maintain
client confidentiality may result in disciplinary action up to and including termination of volunteer duties. If a question arises as
to the confidentiality of any information, consult the Executive Director, Program Director, or a member of The Single Mom KC
Leadership Team.



The Single Mom KC
info@thesinglemomkc.org
11539 W. 83rd Terrace
Overland Park, KS 66214
913.359.0790
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