Volunteer Interest Form

Whether you’re interested in supporting educational outreach, assisting with fundraising events, sharing your personal story, volunteering your time, or serving in a leadership role, your involvement makes a meaningful impact.

Please complete the form below, and a member of the Donate Life NYS team will follow up with you directly.

Volunteer Interest Form

Tell us about yourself.

What is your name?(Required)

First Last

What is your birthdate?

Optional: If provided, we’ll use your date of birth to determine your eligibility to participate in age-based volunteer opportunities.

MM slash DD slash YYYY

Tell us how we can reach you.

What is your mailing address?(Required)

We’ll use your mailing address to share volunteer opportunities in your area and to send occasional mail from Donate Life NYS.

Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code

What is your email address?(Required)

We’ll use your email address to share volunteer opportunities and send other occasional communications.

What is your mobile phone number?

Optional: If provided, we’ll use your mobile phone number to share volunteer opportunities and for occasional calls and/or text messages from Donate Life NYS staff.

Tell us about your background.

What is your occupation?(Required)

Select all that apply.

I am employed or am seeking employment

I am retired

I am a student

Other/Prefer not to answer

Job title

Optional: Indicate your current job title. If you are seeking employment or retired, indicate your most recent job title.

Employer

Optional: Indicate your current employer. If you are seeking employment or retired, indicate your most recent employer.

School

Optional: Indicate the school you attend.

Concentration or Major

Optional: Indicate your concentration or major.

What is your relationship to organ, eye, and tissue donation?(Required)

Select all that apply.

I’m a transplant recipient

I’m a donor’s family member/loved one

I’m a living donor

I’m a recipient’s family member/loved one

I’m waiting for a transplant

I’m a healthcare professional

I’m a registered donor

I’m a general advocate/supporter who wants to help advance a lifesaving mission

Other (please describe)

Other relationship (please describe)(Required)

Tell us about your interests.

Donate Life NYS has a variety of engagement opportunities. Please indicate your areas of interest.(Required)

Select all that apply.

Advocacy/legislative policy engagement

Committee or leadership service

Community awareness opportunities

Digital and traditional communications

DMV ambassador program

Event support

Host a fundraiser or fundraising event

Office support and special projects

Professional/skills-based opportunities

Speaking and storytelling opportunities

Virtual opportunities

Other (please describe)

Other interest (please describe)(Required)

Submit Volunteer Interest Form

By submitting this form, you agree that Donate Life NYS may use the information you provide as described above, including to contact you about volunteer opportunities and send occasional communications. You may withdraw your consent at any time by contacting us.