Donate to Hitchcock Center for Women Wishlist Join
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Donating your time is just as important as donating your money. Volunteering a few hours or weekends makes a tremendous difference in helping the Whollistic Woman complete her journey.

Please use the form below to join our forces.

Basic Information
First Name Last Name
Address
 City
State
Zip
Home Phone
Other Phone
Email Address
 Confirm Email
Employer Information
Company Name (If retired, previous employer) May we contact you at Work?
YesNo
Company Address Company City
Company State
 Company Zip code Company Phone Company Fax Number
Emergency Contact Information
First Name Last Name
Address
 City
State
Zip
Phone
Relationship
Physician First Name
 Physician Last Name
Physician Phone
 Preferred emergency room per insurance:
Please indicate any physical limitations during activities (i.e. lifting, standing, etc)
Volunteering
Volunteer Category:ParentRetireeStudentBusiness OrganizationCommunity Member
If you are volunteering thru a business or as a retiree, please indicate the business name:
Please indicate days available SunMon TuesWedsThursFriSat
how did you hear about hitchcock center?RadioTelevisionInternetReferral
Interests & Abilities
Areas of Interests
Assist with answering phones, filing preparing mailings, copying
Providing support for fundraising activities
Writing (Newsletter) layout, printing
Phone volunteers, identify potential volunteers
Assist with the upkeep of the facility
Hobbies & Crafts Special Skills & Experience
I accept the following Terms and Conditions*:

As a volunteer for Hitchcock Center for Women, Inc., I understand that all volunteers must attend a mandatory training/orientation session.  All Volunteers will be responsible for participating in accordance with the mission and values of Hitchcock Center for Women, Inc.

I hereby fully and forever release and discharge Hitchcock Center for Women, Inc., their employees, trustees, officers and liability insurance carriers from all claims, action, causes of action, liabilities, suites, expenses (including reasonable attorney’s fees) and negligence whether foreseen or unforeseen rising directly or indirectly from any damage, loss or injury to me or my property damages or judgments which I have now or in the future for all personal injuries to myself, known and/or arising out of the activities of myself as a volunteer at Hitchcock Center for Women, Inc.

I am also stating that I am over the age of eighteen (18) and I, the undersigned, have read this release and understand all of its terms, and I execute it voluntarily and with full knowledge of its significance.

Please initial and date the following statement of consent and Criminal Record Release: I agree to Hitchcock Center for Women, Inc. conducting a criminal record check in connection with my registration in accordance with state law.
Date of brith e.g. 01-01-2011
 Driver License/State ID Enter today's date
e.g. 01-01-2011 		Your Initials
*Additional information may be required
Where Your Time Goes
  • Hitchcock has been supporting and empowering women for 30 years.
  • 13,000 women have come home to Hitchcock since 1978.
  • 43 of 100 women successfully complete the average treatment program. 72 of 100 successfully complete the Hitchcock program.
  • We serve up to 60 women in treatment and Transitional Housing at any given time.