Volunteer Application Form

Please enter a title Mr. Mrs. Ms. Dr.

Name May I have your name?

Address May I have your address?

Phone May I have your phone number?

E-mail May I have your email address?

Do you have a driver’s license and are you able to drive? Do you Drive And have a License? Yes No

Are you in good health and would you have any problems lifting boxes weighing around 20 to 30 pounds? Good health and can lift boxes weighing around 20 to 30 pounds? Yes No

Would you be interested in solicitation by phone work to request donations of product that would be helpful to the needy? Are you willing to solicit for our cause? Yes No

Do you need community service for High School or for a court order? Community service for High School or for a court order? Yes No

Do you have any talents or professional expertise that could be a benefit in a crises situation, such as counseling, crises hotline work, plumbing, electrical work, carpentry, etc? Feel free to explain if you wish:

Are you free of any legal concerns that could hinder the security of our volunteer work?Any Legal Concerns? Yes No
Please Explain: If you choose Yes above, we insist you tell us why!

Thank you for your cooperation in filling out this form.