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Required fields are marked with an asterisk (*). First name *
Middle name
Last name *
Street address *
Street address (line 2)
City
State
Zip *
Mobile phone
For example, 123-456-7890
SMS (text) messaging:
You may opt-in to receive SMS (text) for City of Bloomington, MN volunteer activities, including shift reminders and cancellations.
To opt-out, reply STOP to any SMS message OR update the SMS opt-in setting in your profile.
Preferred pronouns
Please share
Race or Ethnicity
Please share here
Age range (for demographic use only)
Emergency contact #1 name and phone
Emergency contact #2 name and phone
Please indicate volunteer interests
Select all areas of interest
Other interests
Please share experience, training, certifications, language abilities, and other skills that apply.
The City of Bloomington does not discriminate on the basis of disability in the admission or access to, or treatment or employment in, its services, programs, or activities. Upon request, accommodation will be provided to allow individuals with disabilities to participate in all City of Bloomington services, programs, and activities. If you have questions, please contact Community Outreach and Engagement at outreach@BloomingtonMN.gov or 952-563-8733 | MN Relay 711.
Please let us know if you have any specific needs for participation. A staff person will contact you to discuss further.
The data supplied on this form will be used to enroll you in a volunteer program. Per Minnesota State Statute, the requested data is private. It is available to you, as well as the City of Bloomington staff who need this information to perform their duties. It is not available to the public. You are not legally required to provide this data, but the City of Bloomington staff may not be able to
complete your registration and/or you may not receive updated information.
How did you learn about volunteer opportunities with the City of Bloomington? *
Other: How did you learn about volunteer opportunities with the City of Bloomington? *
