Date:
7/5/2008
General Information
Name:*
E-Mail:
Address:*
City:*
State:*
Zip:*
Phone:*
Phone:*
Phone:*
Birthday:
*Only Month and Date
ADA Requirements Needed:
Emergency Contact Information
Name:*
Phone:*
I. Skills and Interests*
Education/Background:
Current Occupation:
Hobbies, Skills, Interests:
Volunteer Experience:
II. Preferences in Volunteering
What type of work are you interested in? Check all that apply.
General Administrative Work
Public Speaking
Event Project Planning
Data Entry
Bulk Mailing
Participation in service project
Working as a staff assistant
Research
Graphic Design
No Preference
Fund-Raising
Grants,Writing, & Management
Vision and Hearing Screening
Other:
III. Availability *
What times are you available or interested in volunteering?
I am Flexible
Prefer Weekdays
M
Tu
W
Th
F
If you can only work certain days of the week, please check those days. If you can work any days of the week, please check that you are flexible.
Number of hours you can commit:
