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Name

Street Address

City ST ZIP

Email Address

Home Phone

Work Phone

Availability
 Weekday mornings

 Weekend mornings

 Weekday afternoons

 Weekend afternoons

 Weekday evenings

 Weekend evenings

Interests
Tell Us in which areas you are interested in volunteering

 Administration

 Events

 Community work

 Fundraising

 Programming

 Marketing

 Newsletter production

 Volunteer coordination

Special Skills or Qualifications
Summarize special skills and qualifications you have acquired from previous volunteer work or through other activities.

Previous Volunteer Experience
Summarize your previous volunteer experience.

Person to Notify in Case of Emergency

Name

Street Address

City ST ZIP

Email Address

Home Phone

Work Phone

Agreement and Signature
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.

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Our Policy

It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.

Thank you for completing this application form and for your interest in volunteering with us.

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