Volunteer at Facility | Veteran Affairs

Volunteer at a Facility

Thank you for your interest in making a difference in the lives of Veterans! To provide you with more information regarding your interest in serving America's Veterans, please provide your contact information below and click 'Submit'. All fields marked with an asterisk are required.

Note: If you have any questions about your request, you are welcome to directly contact the VA Center for Development and Civic Engagement office, sometimes referred to as Voluntary Service, at the nearest VA Medical Center. If you would like to offer support at the national level, please select District of Columbia - Veterans Health Administration.

Please select the State and Facility where you wish to provide service:

Volunteer Type

IndividualGroup or Organization

State

Facility

Please enter your contact information below:

First Name

Last Name

Pronoun

IF YOU'D LIKE TO, PLEASE SHARE YOUR PRONOUNS

Corporate / Civic / Community / Veterans' Group Membership (if applicable)

Date of Birth

Group/Organization Name

Enter Address Manually

NoYes

Street Address

Apt/Suite/Other

City

State

ZIP/Postal Code

Preferred Phone Number

Home Phone

Work Phone

Mobile Phone

E-mail

Preferred Method of Contact

MailEmailPhoneNo Preference

Emergency Contact

Emergency Contact Phone

Emergency Contact Relationship

Volunteer Morning List

Volunteer Afternoon List

Volunteer Evening List

Please provide us any additional information we need to be aware of to best place you in a volunteer opportunity. This may include special considerations, restrictions, or interests. (Limit to 500 characters)

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The Paperwork Reduction Act of 1995 requires us to notify you that this information collection is in accordance with the clearance requirements of section 3507 of the Paperwork Reduction Act of 1995. We may not conduct or sponsor, and you are not required to respond to a collection of information unless it displays a valid OMB number. We anticipate that the time expended by all individuals who must complete this form will average 15 minutes. This includes the time it will take to read instructions, gather the necessary facts and fill out the form. The form is used to assist personnel of both voluntary organizations, which recruit volunteers from their membership, and the VA in the selection, screening and placement of volunteers in the nationwide VA Voluntary Service program. The volunteer program supplements the medical care and treatment of veteran patients in all VA medical centers.

Privacy Act Information
The information requested on this form is solicited under the authority of 38 U.S.C. 513 and will be used in the selection and placement of potential volunteers in the VA Voluntary Service Program. The information you supply may be disclosed outside VA as permitted by law; possible disclosures include those described in the "routine uses" identified in the VA system of records 57VA125 Voluntary Service Records-VA, published in the Federal Register in accordance with the Privacy Act of 1974. The routine uses include disclosures: in response to court subpoenas, to report apparent law violations to other Federal, State or local agencies charged with law enforcement responsibilities, to service organizations, employers and Unemployment Compensation Offices to confirm volunteer service, and to congressional offices at the request of the volunteer. Disclosure of the information is voluntary, however, failure to furnish the information will hamper our ability to arrange the most satisfactory assignment for you and the Department of Veterans Affairs. Disclosure of the Social Security number is voluntary. The number will be used in the identification or records.

About Donations to VA
VA medical center directors have authority to accept gifts pursuant to 38 USC 8301 and VHA Handbook 4721 for the general benefit of the medical center and the Veterans we serve. The Chief, Center for Development and Civic Engagement (CDCE) at each VA medical center may accept gifts that benefit the facility and its patients except for gifts for research and education. Donations provide Veteran patients with many essential services and programs that otherwise would not be available to them, such as transportation services, social service assistance, rehabilitation equipment, recreation programs, activities, homeless Veteran's services, holiday gifts, phone cards and many other options. Your donations are 100 percent tax deductible and all administrative costs for VA are already appropriated by Congress, so you can be assured your entire donation is going directly to support Veterans in the way you choose.