Volunteer Application

Filling out this application is your first step to volunteering with Atlanta's leading nonprofit feminist health care resource.

Thank you for your interest in FWHC’s Volunteer Programs! Please complete the below application and we will contact you soon to start the orientation process by scheduling your volunteer orientation. If you have any questions, contact the Volunteer Coordinator at This email address is being protected from spambots. You need JavaScript enabled to view it. or 404.248.5445.

Contact Information

Items with * are required.
Full Name *

Enter your full name
Street Address *

Enter your address.
Primary Phone *

Please provide us with your most used phone number.

Please specify the type of number.
Occupation *

Enter your occupation.
How did you hear about us? *

Please tell us how you heard about us.
Your Email *

Please let us know your email address.
City, State & Zip *

Enter your city, state & zip.
Alternate Phone

Please provide us with another number.

Please specify the type of number.
Current Employer and/or School (if any)

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Skills & Past Experience

Items with * are required.
Computer Skills *

Please enter your computer skills.
Past Experience *

Please enter your past experiences.
Languages *

Please enter your language skills.
Other Skills

Demographic Information

Note: This section is optional but it helps us evaluate our programs.
Preferred Pronoun

I identify as








My ethnicity/racial identity is
Date of Birth

My age is








My Sexual Orientation is

Time Commitment

Items with * are required.
Which times do you prefer to volunteer? (Check all that apply.) *

Please select at least 1 time that you are available to volunteer.
Please provide any additional comments about scheduling and time frames

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Motivations for Volunteering

Items with * are required.
FWHC Programs of Interest (check all that apply) *











Please list at least one FWHC program of interest.
Please indicate any specific volunteer interests


Preference of work environment (check all that apply) *





Please select your preference.
Will volunteering at FWHC fulfill a community service or school requirement? *

Please indicate yes or no.
If this is a school requirement, please explain.
Volunteer Interests and Skills (check all that apply) *



























Please choose at least one.
Other Interests or Skills

Emergency Contact

Items with * are required.
Emergency Contact *

Enter your Emergency Contact
Relationship *

Enter your emergency contact's relationship to you.
Emergency Contact Phone *

Enter your emergency Contact Phone

Non-Family Reference

Complete Name, Adddress, Zip Code & Phone Number Required.


Full Name *

Enter a name of a non-family reference.
Street Address *

Enter your reference's address.
City, State & Zip *

Enter your city, state & zip.
Phone *

Enter your reference's phone.
Email

Please let us know your reference's email address.

"At Will" Volunteer & Equal Opportunity Statement


The Feminist Women's Health Center is neither obligated to utilize your services as a volunteer nor are you obligated to accept the volunteer assignments offered. The Feminist Women’s Health Center is an Equal Opportunity organization. We do not discriminate on the basis of gender, gender identification, gender expression, sexual orientation, race, color, ethnic or religious background, descent or nationality, disability or disease, marital status, age, height or weight.

Statement of Responsibilitiy *


If accepted as a volunteer, I pledge to hold in strict confidence, all personal and official matters that come to my attention. It is my responsibility to respect and preserve the privacy of the clients as well as any details involved and I understand that I will be required to sign a Confidentiality Agreement.


You are required to agree
Comments or Questions?

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Feminist Women's Health Center

women's health resource1924 Cliff Valley Way NE

Atlanta, GA 30329

Community Outreach 404.248.5445

Clinic 404.728.7900 Toll Free 800.877.6913

501(c)3 Non-Profit Organization

non-profit charitable organizationHelp Support a Woman in Need

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