Please select your highest completed level of education.
Skills & Experience
Please check all that apply.
Please select any language that you can read, write, and speak fluently.
Please tell us more about the skills and experience that you'd like to contribute to FixNation.
Please select any times that are convenient for you. Our clinic is open Wednesday-Saturday from 7am-5pm, but there are volunteer opportunities outside of these days and hours.
Please select any days that are convenient for you. Our clinic is open Wednesday-Saturday from 7am-5pm, but there are volunteer opportunities outside of these days and hours.
Please let us know how frequently you'd like to volunteer with FixNation. Selecting a frequency here does not commit you to any set time to volunteer.
Specific Volunteer Opportunities
Please check any that you are interested in assisting with.
Submitting this application
I understand and agree that submitting this application form does not automatically register me as a FixNation volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering. By submitting this form, I attest that the information I have provided on the form is true and accurate.