Volunteer Form

Parent Volunteer Application

Our parent volunteers are the face of Jack’s Basket with both families and medical providers. They are critical to our mission to ensure that every new and expectant parent is provided resources and avenues of support within the community; from one parent to another. The approximate time commitment expected of a parent volunteers is an average of 4-6 hours per month dependent on region and volunteer role.

Qualifications

• A parent of a child with Down syndrome ideally between the ages of 6 months and 10 years

• Aligned with the mission of Jack’s Basket

•Empathetic and able to communicate with families from diverse backgrounds and experiences, meeting them “where they are” on their new journey as parents

• Prepared to share their own experience as a parent of a child with Down syndrome

• Well-organized with strong time management and communication skills

• Willing to drive distances of up to 30 miles (or 45 minutes)

• Able to communicate in a timely manner to parents and HQ

• Commitment to Jack’s Basket Statement of Support and Confidentiality

Key Responsibilities

• Respond within 6 hours to confirm availability when made aware of a new basket request needing a parent connection

• Connect with family on a basket request via call, text, or in-person basket delivery

• Follow Jack’s Basket guidelines when meeting or connecting with a family

• Confirm when a connection is complete, including sending photos along with any feedback, per guidelines

• Reconnect with families you have met a couple of times, such as 3 months, 6 months, and 12 months later or during major milestones, surgery, etc

• Keep track of your basket inventory on hand. Store and transport baskets in clean, stable, and safe conditions

• Attend at least one annual training session per year.

• Active participation in annual Jack’s Basket events is encouraged

Additional responsibilities of the RLP (Regional Lead Parent) role:

• Establish and maintain contacts at local hospitals or clinics to encourage requests for baskets and communication about the program to staff

• Facilitate meetings at the hospitals and clinics in their area. Replenishing materials for medical providers

• Host an annual fundraising effort, such as a pancake breakfast or online fundraiser tied to a local 5K, to create awareness and raise money to support baskets

• Attend meetings with HQ and other RLPs for updates and a chance to share your successes

Parent Volunteer Application Form

Name(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

Address Line 1 Address Line 2 City State / Province / Region ZIP / Postal Code Country

What language(s) do you speak?(Required)

What's your occupation?(Required)

What are three words that describe you?(Required)

Who referred you to be a Jack's Basket Parent volunteer?(Required)

Your child's name(Required)

First Last

Your child's birthdate(Required)

Has your child had a heart surgery?(Required)

Yes

Was the diagnosis given at birth or prenatally?(Required)

Birth diagnosis

Prenatal diagnosis

What was your experience when your child was diagnosed with Down syndrome? Share your story:(Required)

What other details of your child's diagnosis would help you relate to other parents?

Additional health concerns, stay in the NICU, etc.

Why do you want to be a parent volunteer for Jack's Basket?(Required)

What skills or experience do you have that you feel would be useful in communicating with medical professionals regarding the Down syndrome diagnosis and Jack's Basket programming?(Required)

Which parent volunteer role are you interested in?(Required)

Basket Delivery Parent

Regional Lead Parent

Did you receive a Jack's Basket?(Required)

Yes

What impact did receiving the Jack's Basket have on your story?(Required)

Please provide the names and emails of at least two personal or professional references. Our team will be in contact them during your application process.

Reference #1(Required)

First Last

Email(Required)

Relationship

Reference #2(Required)