Career and Volunteer Interest Form - Vital Ability, LLC

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Careers & Volunteer Interest Form

Thank you for your interest in Vital Ability LLC!

We appreciate your desire to become part of our growing organization.

Whether you're interested in future employment, volunteering, collaborating, facilitating educational programs, contributing content, or supporting our mission in another way, we'd love to learn more about you.

Please complete the information below. Submission of this form does not guarantee placement or future opportunities but allows us to contact you as opportunities become available.


How did you hear about us? 
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What is the best way to contact you for follow-up from this form?{"type":"checkbox","name":"__generic2","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please check at least one item.","options":"Phone call\nText\nEmail\nVideo Chat"}



Personal Information:

Full Name:  prefixMr.Mrs.Ms.MissDr. Prof.Hon.SirCllrMsgr.LadyLordGeneralCaptainFatherRevEarl{"type":"select","name":"__generic3","width":14,"value":"","size":"Normal","validation":"","validationMessage":"Please make a selection for this item.","options":"prefix\nMr.\nMrs.\nMs.\nMiss\nDr. \nProf.\nHon.\nSir\nCllr\nMsgr.\nLady\nLord\nGeneral\nCaptain\nFather\nRev\nEarl"}

: {"type":"text","name":"__generic4","width":65,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":""}

                                          First Name
                                          {"type":"text","name":"__generic5","width":65,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":""}


                       Last Name

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Preferred Name (otional)

Email Address: {"type":"text","name":"__generic7","width":75,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":""}


Primary Phone Number: {"type":"text","name":"__generic8","width":35,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":""}


Mailing Address:  

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                     Street Address
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  Street Address Line 2
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  {"type":"text","name":"__generic10","width":50,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":"State"}


  {"type":"text","name":"__generic11","width":18,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":"Zip Code "}



  select hereUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorra AngolaAnguillaAntigua and BarbudaArgentinaArmeniaAruba AustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbedosBelarusBelgiumBelizeBeninBermuda BhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodia CameroonCanadaCamp VerdeCayman IslandsCentral African RepublicChadChileChineChristmas IslandCocos (Keeling) IslandsColumubiaComorosCongoCook IslandsCosta RicaCote d'lvoireCroatiaCuba CaracaoCyprusCzech RepublicDemocratic Republic of the CongoDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGayanaHaitiHondurasHong Kong HungaryIcelandIndiaIndonesiaIran IraqIreland IsraelItalyJamaicaJapanJersey JordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacadamiaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNagorno-KarabakhNamibiaNauruNepalNetherlandsNetherland AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandTurkish Republic of Northern CyprusNorthern MarianaNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcaim islandsPoland PortugalPuerto RicoQatarRepublic of the CongoRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartiSaint Pierre and MiquelonSaint Vincent and the GranadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia SeychellesSierra Leone SingaporeSlovokiaSlovaniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiSpainSri LankaSudanSurinameSvalbardeSwatiniSwedenSwitzerlandSyria TaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTransnistria PridnestrovieTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanatuVatican CityVenezuelaVietnamBrtish Virgin IslandsIsle of ManUS Virgin IslandsWallis and FatunaWestern SahraYemen ZambiaZimbabweOther{"type":"select","name":"Country","width":40,"value":"","size":"Normal","validation":"N1","validationMessage":"Please make a selection for this item.","options":"select here\nUnited States\nAfghanistan\nAlbania\nAlgeria\nAmerican Samoa\nAndorra \nAngola\nAnguilla\nAntigua and Barbuda\nArgentina\nArmenia\nAruba \nAustralia\nAustria\nAzerbaijan\nThe Bahamas\nBahrain\nBangladesh\nBarbedos\nBelarus\nBelgium\nBelize\nBenin\nBermuda \nBhutan\nBolivia\nBosnia and Herzegovina\nBotswana\nBrazil\nBrunei\nBulgaria\nBurkina Faso\nBurundi\nCambodia \nCameroon\nCanada\nCamp Verde\nCayman Islands\nCentral African Republic\nChad\nChile\nChine\nChristmas Island\nCocos (Keeling) Islands\nColumubia\nComoros\nCongo\nCook Islands\nCosta Rica\nCote d'lvoire\nCroatia\nCuba \nCaracao\nCyprus\nCzech Republic\nDemocratic Republic of the Congo\nDenmark\nDjibouti\nDominica\nDominican Republic\nEcuador\nEgypt\nEl Salvador\nEquatorial Guinea\nEritrea\nEstonia\nEthiopia\nFalkland Islands\nFaroe Islands\nFiji\nFinland\nFrance\nFrench Polynesia\nGabon\nThe Gambia\nGeorgia\nGermany\nGhana\nGibraltar\nGreece\nGreenland\nGrenada\nGuadeloupe\nGuam\nGuatemala\nGuernsey\nGuinea\nGuinea-Bissau\nGayana\nHaiti\nHonduras\nHong Kong \nHungary\nIceland\nIndia\nIndonesia\nIran \nIraq\nIreland \nIsrael\nItaly\nJamaica\nJapan\nJersey \nJordan\nKazakhstan\nKenya\nKiribati\nNorth Korea\nSouth Korea\nKosovo\nKuwait\nKyrgyzstan\nLaos\nLatvia\nLebanon\nLesotho\nLiberia\nLibya\nLiechtenstein\nLithuania\nLuxembourg\nMacau\nMacadamia\nMadagascar\nMalawi\nMalaysia\nMaldives\nMali\nMalta\nMarshall Islands\nMartinique\nMauritania\nMauritius\nMayotte\nMexico\nMicronesia\nMoldova\nMonaco\nMongolia\nMontenegro\nMontserrat\nMorocco\nMozambique\nMyanmar\nNagorno-Karabakh\nNamibia\nNauru\nNepal\nNetherlands\nNetherland Antilles\nNew Caledonia\nNew Zealand\nNicaragua\nNiger\nNigeria\nNiue\nNorfolk Island\nTurkish Republic of Northern Cyprus\nNorthern Mariana\nNorway\nOman\nPakistan\nPalau\nPalestine\nPanama\nPapua New Guinea\nParaguay\nPeru\nPhilippines\nPitcaim islands\nPoland \nPortugal\nPuerto Rico\nQatar\nRepublic of the Congo\nRomania\nRussia\nRwanda\nSaint Barthelemy\nSaint Helena\nSaint Kitts and Nevis\nSaint Lucia\nSaint Marti\nSaint Pierre and Miquelon\nSaint Vincent and the Granadines\nSamoa\nSan Marino\nSao Tome and Principe\nSaudi Arabia\nSenegal\nSerbia \nSeychelles\nSierra Leone \nSingapore\nSlovokia\nSlovania\nSolomon Islands\nSomalia\nSomaliland\nSouth Africa\nSouth Osseti\nSpain\nSri Lanka\nSudan\nSuriname\nSvalbard\neSwatini\nSweden\nSwitzerland\nSyria \nTaiwan\nTajikistan\nTanzania\nThailand\nTimor-Leste\nTogo\nTokelau\nTonga\nTransnistria Pridnestrovie\nTrinidad and Tobago\nTristan da Cunha\nTunisia\nTurkey\nTurkmenistan\nTurks and Caicos Islands\nTuvalu\nUganda\nUkraine\nUnited Arab Emirates\nUnited Kingdom\nUruguay\nUzbekistan\nVanatu\nVatican City\nVenezuela\nVietnam\nBrtish Virgin Islands\nIsle of Man\nUS Virgin Islands\nWallis and Fatuna\nWestern Sahra\nYemen \nZambia\nZimbabwe\nOther"}

  Country

Tell Us About Yourself

Which of these best describes your interest(s)
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If Other, please tell us what interests are not listed?
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Professional Background

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{"type":"text","name":"__generic18","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":"Employer (optional)"}



{"type":"text","name":"__generic19","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","placeholder":"Professional Certifications, Licensure, or Credentials"}



Highest Level of Education
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If Other, please tell us about your other education?
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Areas of Expertise

{"type":"checkbox","name":"__generic22","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please check at least one item.","options":"Coaching\nLeadership\nHealthcare\nDisability\nBrain Injury\nMental Health\nEducation\nPublic Speaking\nCurriculum Development\nAdult Learning\nPublic Health\nWriting\nResearch\nGraphic Design \nMarketing\nSocial Media\nNonprofit\nAdvocacy\nBusiness\nTechnology\nProject Management\nOther"}


If Other, please tell us what field your expertise is in?
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Lived Experience

We recognize that both professional expertise and lived experience provide valuable perspectives.

Do you have specific lived experience(s) you would like to share?
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If Other, please elaborate if you feel comfortable doing so.
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Availability

How would you like to contribute?
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If Other, please provide details about your availability.
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Why Vital Ability?

{"type":"textarea","name":"__generic28","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":"Why interested?"}


Experience

Tell us about any relevant education, volunteer work, employment, certifications, presentations, leadership roles, or community involvement.

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Resume'

Would you like to provide a resume or CV?
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File Upload of jpg or jpeg of your resume here . {"type":"image","name":"__generic31","width":null,"value":"","size":"Normal","validation":"","validationMessage":"Please provide an image for this item.","maxlength":3,"placeholder":"File Upload of jpg or jpeg of your resume here . "}


 If submitting resume by Word or PDF, please email instead to myvitalability@gmail.com

{"type":"textarea","name":"__generic32","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":"Portfolio or Website (optional)"}


{"type":"textarea","name":"__generic33","width":100,"value":"","size":"Normal","validation":"","validationMessage":"Please fill in this item.","height":80,"placeholder":"LinkedIn (optional)"}


References

Would you be willing to provide professional references if requested?
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Future Communications

Would you like to receive updates regarding:
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Do you have any specific questions or comments we can answer?
{"type":"textarea","name":"__generic36","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","height":80,"placeholder":""}


Agreement

I understand that submittin this form does not guarantee placvement, employment, volunteer opportunities, or future collaboration.
I certify the information provided is accurate to the best of my knowledge.
{"type":"checkbox","name":"__generic37","width":100,"value":"","size":"Normal","validation":"C1","validationMessage":"Please check at least one item.","options":"I agree."}



{"type":"signature","name":"__signature","width":100,"value":"","size":"Normal","validation":"NE","validationMessage":"Please enter your signature.","height":150}


Date: {"type":"text","name":"__generic38","width":25,"value":"","size":"Normal","validation":"NE","validationMessage":"Please fill in this item.","placeholder":"Date: 00/00/0000"}


Thank you for your interest in Vital Ability LLC.


We appreciate your willingness to share your time, talents, experience, and passion with our growing organization.


As opportunities arise that align with your interests and qualifications, we may contact you regarding the next steps.


We are honored you have reached out to us and will be getting back to you as soon as possible.  


You can reach us for additional questions at:
616-730-1204

    Support. Transition. Transform.


Sincerely,
Caren Robinson - Founder





PERSONAL DATA
The provision of personal data (“Data”) in this form is voluntary and will be used to utilize the Career and Volunteer Interest Form or to provide additional information about requested items. If you fail to supply the data requested herein, we may be unable to process your application for information, and you will be unable to submit this form. 


The data may also be used for any of the following purposes:

  • providing program services;
  • performing administrative matters, communication and liaison concerning the  programs, Vital Ability LLC, and their respective associates or affiliates;
  • promoting program and events;
  • any other legitimate purposes as may be required, authorized or permitted by law

The data may be used, stored, disclosed, and transferred by Vital Ability LLC to its associates and affiliates, any government department or regulatory body if required by law, and any individuals/organizations associated with the programs herein, including its agents and contractors, for the purposes specified above.


If you would like to request access to and/or correction of the data retained by us, please e-mail us at myvitalability@gmail.com. Any requests for access to and correction of information will be dealt with as promptly as possible.