| red * color - denotes required fields |
| Name: * |
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| Address: * |
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| City: * |
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| State: * |
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| Zip Code: * |
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| Home Phone: * |
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| Work Phone: |
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| Cell Phone: |
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| Email Address: * |
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| Have you been convicted of a felony within the past five years? |
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| If yes, please explain:: |
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| Are you a student? |
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| If yes, what school do you attend? |
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| If yes, what grade or year are you in? |
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| Have you done volunteer work at another nonprofit? |
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| If yes, where and what did you do? |
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| What type of work would you like to do here: |
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| List any hobbies, or interests: |
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| What skills, training, or knowledge do you wish to utilize here? |
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| Why do you want to volunteer here? * |
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| Where did you hear about our volunteer program? |
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| When would you be able to start? * |
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Which Shifts would you be available to volunteer? *
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| How many shifts per month do you prefer? |
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| Comments concerning your availability: |
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| If you have a disability, what accommodation would you need to do this volunteer position: |
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| Please provide 3 personal or professional references: *
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| In case of emergency, please contact: *
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| Medical information we should be aware of in an emergency (allergies, special medications, &/or conditions): |
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