Volunteer Information Form

             Personal Information

Mr. Mrs. Ms. Dr.

Name
Address
Phone
E-mail

Questions:

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

Are you in good health and would you have any problems lifting 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?   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?    Yes No   Please Explain:

Thank you for your cooperation in filling out this form.