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for Veterans and their families

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Clay Veterans Center
2497-1 CR 220 Middleburg, FL 32068
office 904-375-1354 text 904-658-0105

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Clay Veterans Volunteer Application

First name*

Last name*

Email*

Phone*

Preferred Method of Contact*

Phone Call

Text

Email

Emergency Contact Name*

Emergency Contact Phone Number*

Relationship of Emergency Contact

Please select days and time of day available for scheduling

Mondays

Mornings

Afternoons

Tuesdays

Mornings

Afternoons

Wednesdays

Mornings

Afternoons

Thursdays

Mornings

Afternoons

Fridays

Mornings

Afternoons

I'm most interested in volunteering in these programs:

Service Support Team Member (Front-facing at Vet Ctr)

Open-Door Team Member (Comradery with Vets One-to-One at Vet Ctr)

Vet Tech Team Member (Technical assistance One-to-One at Vet Ctr)

Family Support Team Member

Comraderie Program Leader/Team Member

Community Engagement Leader/Team Member

Volunteer Virtually

Other

Skills and Background - Highest Education Level

Military Affiliation

Veteran

Veteran Family Member

Active Duty / Reserve / Guard

Civilian Supporter

Other

Branch of Service

Army

Navy

Air Force

Marine Corps

Coast Guard

Space Force

Doesn't Apply

Have you ever been charged with a felony? *

Yes

No

Have you ever been convicted of a felony? *

Yes

No

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A copy of the official registration and financial information may be obtained from the Division of Consumer Services by calling 1-800-HELP-FLA (435-7352) or FDACS.gov. Registration does not imply endorsement, approval, or recommendation by the State of Florida.

Clay Veterans Center

2497-1 CR 220

Middleburg, FL 32068

(904) 375-1354

(Directly behind Doctor's Inlet Veterinary Hospital)

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