2024-25 Application Form - nyfriendshipcircle.com

Address

Cell Phone

Area Code Phone Number
E-mail
Preferred method of contact

TextE-mail
Emergency Contact Name
First Name Last Name
Emergency Contact Number
Do you have any concerns about volunteering?
Do you have any talents or hobbies that you would like to share with Friendship Circle friends?
Volunteers over 18 require a background check. After we meet, we will email you a background check form to fill out.

If you are 18 and younger please fill out the boxes below. Thank you!
Volunteers 18 and Under Continue Below
Parent/Guardian Name
First Name Last Name
Parent/Guardian Cell Number

Area Code Phone Number
Parent/Guardian E-mail
Parental Consent
(18 years old and under)
I give my teen permission to volunteer in The New York Friendship Circle at The Chai Center.
Permission to volunteer

YesNo
I understand that Friendship Circle events may be live streamed and photos may be taken. I understand my child’s likeness may be used in print or digital media with no names. Names will not be used unless unless express permission is given to use my or my child’s name.
Permission for use of my child's likeness

YesNo
Signature of Parent
Please initial your consent. I understand that my initial is legally binding as a print signature.
Date of Application

Month Day Year
Should be Empty:

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Ariella's NY Friendship Circle