05/19/2022 Application Assistance Registration

First Name*

Last Name*

Phone Number:

Email Address*

School/Company/Law Firm/Affiliation:*

I am a(n)...*

Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

What languages, other than English, do you speak fluently?

Only list languages in which you could converse with an applicant to complete an application.

Other language:

Confidentiality Policy*

As a volunteer for Project Citizenship, I understand the importance of maintaining confidentiality. I also understand that anyone seeking assistance from Project Citizenship is considered to be a client of Project Citizenship and not of any individual.

I pledge not to disclose confidential or personal information about anyone seeking assistance from Project Citizenship to third parties without the consent of the individual. If I have any questions regarding confidentiality, I will consult with a Project Citizenship staff member before divulging information to any other person.

By checking this box, I am bound to keep all information, including that which concerns individuals seeking assistance, applicants, attorneys, and volunteers, confidential. This is the case both during and after my volunteer commitment. I will delete any information from my device after my volunteer commitment ends.

I agree to the Confidentiality Policy.

Phone

This field is for validation purposes and should be left unchanged.

05/19/2022 Application Assistance Registration

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