Twitter Full Legal Name (to verify ID with Volunteer Agreement) * Preferred Name Address * Address Line 2 City * State * Select a State/ProvinceAlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUnited States Minor Outlying IslandsUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code * Phone Number * Do you speak any languages in addition to English? Check all that apply. Arabic American Sign Language (ASL) Cantonese Farsi French Filipino German Hindi Indonesian Japanese Khmer/Cambodian Korean Mandarin Russian Spanish Tagalog Thai Ukrainian Vietnamese Other, please fill in below If you speak a language that is not listed, please tell us: Are you an IRS Employee? * Yes No Were you referred to CASH Oregon by the IRS? * Yes No Emergency Contact Name * Emergency Contact Relationship * Emergency Contact Phone * Demographic Information We value diversity in our program and use demographic information to ensure inclusivity. These questions are optional and any responses are confidential. 1. Date of Birth (Optional) 2. I identify my gender as (optional - select all that apply) Male Female Transgender Male Transgender Female Nonbinary Genderqueer/gender-nonconforming Different Identity Prefer not to say Not Listed 3. I identify my race/ethnicity as (optional - select all that apply) Asian Black Indigenous Latino/Hispanic Middle Eastern Native Hawaiian or Pacific Islander North African Slavic White Unknown Prefer not to say Not Listed 4. What’s your employment status? (optional - select all that apply) Employed (full time) Employed (part time) Student (full time) Student (part time) Retired Unemployed (seeking employment) Unemployed (not seeking employment) Not Listed 5. What’s your professional background? (Optional) 6. Do you have any skills and experience that you would want to use or develop in our program? (Optional)
