MyImpactPage - Application Form - Gallagher Services

Service Agreement

Please note:

By logging in or creating an account below, you are starting an application to work with Gallagher Services, a program that supports adults who have intellectual disabilities. There is no "draft" setting, so please complete the application all the way to "submit" or changes will be lost.
Volunteers who are 14 and under who are working directly with the people we support must have adult supervision. 15 and older can volunteer independently with check-ins with volunteer supervisor.

You agree to:

- abide by the policies and procedures of the organization
- attend orientation prior to the start of volunteering
- notify the appropriate person if unable to volunteer
- hold as confidential any private information obtained directly or indirectly concerning the people we support

I am new to MyImpactPage.com

You will need to enter a unique username to identify yourself to the system. You should select something that is easy for you to remember such as your email address or your name. Your username must be at least 6 characters long. If the name you enter is already in use by someone else, you will be prompted to choose another username.

Username

Required

	Username must not start with space
	Username must not end with space
	Username must not have two or more spaces in a row

Email Address

Required

Verify Email Address

Required

I understand the Service Agreement above. Required

I already have a username

If you have signed up with this organization before, or are a member of another organization that uses MyImpactPage.com, you can use the same login to access all organizations with which you are associated.

Username	Required
Password	Required
Forgot your username or password?
I understand the Service Agreement above. Required

Already use MyImpactPage.com to volunteer with this organization? Go to volunteer login

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