Email*

First name*

Last name*

Phone number*

What region of Virginia best describes where you would like to volunteer?*

Northern Virginia (includes Fredericksburg, Culpeper, Fairfax County)

Central Virginia (includes Richmond, Charlottesville, Lynchburg)

Shenandoah Valley (includes Staunton, Harrisonburg, Winchester)

Southwestern (includes Roanoke and Abingdon)

Eastern Shore

Tidewater (includes Williamsburg, Norfolk, Virginia Beach)

I do not live in Virginia

I live outside of the United States

Are you volunteering through your employer/organization?*Please SelectYes, I am volunteering through my employer/organizationI am an independent volunteerI am a student volunteering through my schoolOther

If you are volunteering through your employer/organization, which one?

If you are volunteering through your school, which one?

If you are volunteering through your employer, organization or school, who is the main point of contact for this group and their email address? If it is you, please just state "myself".

What skills do you bring to CodeVA? Check all that apply.*

Working with computers, robotics, or electronics

Teaching (any grade level)

Out-of-School Time activities (e.g. summer camps, after-school groups)

Arts and crafts

Administrative (e.g. data entry, writing letters, mailing, copying)

Marketing/Fundraising

Event planning

Other

Describe your experience with the skill(s) you checked in the question above*

Do you speak a language other English, and would you be willing to assist with translation to help us serve our diverse communities?Please SelectNo, I only speak English.Yes, I speak another language but prefer not to assist with translation.Yes, I speak another language and would be willing to assist with translation.

If you answered yes, what language(s) do you speak?

Which sentence describes you best?*

I like working behind the scenes

I like working with people

What interests you most about working with CodeVA?*

What is your availability to volunteer with us? Check all that apply.*

Mornings (8 AM to Noon)

Afternoons (Noon to 5 PM)

Evenings (5 PM on)

Weekdays

Weekends

Seasonal

Year-Round

Because we work with kids, a background check may be required. Note: All Volunteers 18 years of age and older are required to take a criminal background check through us (free of charge) or provide your own recent background check documents. If you are volunteering through an employer/organization, your employer will provide us with your background check verification. Volunteers and students under the age of 18 are NOT required to undergo a background check.*Please SelectI'm OK with it. Let me know what I need to doI would like more information before consenting to a background checkI am under 18 years of age

Do you have any questions or anything else you'd like to share with us?  

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