Individual Volunteer Intake Form
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All contact information is confidential. We do not disclose any information to other organizations or individuals.
Today’s Date:_________________
Personal Information
Name:
Date of Birth:
*Parent/Guardian Name:
*(required for ages 17 or younger)
Street Address:
City ST ZIP:
Home Phone:
Work Phone:
Cell Phone:
E-Mail Address
What is the best way to contact you Home Phone Work Phone Cell Phone E-Mail
Emergency Contact Information (
Required
)
Emergency Contact
(
not accompanying you today
)
Relationship:
Phone:
Additional Information/Availability
When are you available to volunteer:
Monday
Saturday
Morning
Tuesday
Sunday
Afternoon
Wednesday
Evening
Thursday
Friday
Are you a student volunteering to fulfill a certain amount of community service hours?
Yes
No
Name of School: ___________________________________________________________________
Number of hours needed: _________ Deadline to complete required hours: ___________________
Interests/Qualifications
Tell us in which areas you are interested in volunteering
Advocacy
Data Entry
Fundraising
Clerical
Events
Kids Division
Community Services
Food Drives
Mailings
Computer/Technical
Food Sorting & Stocking
Off-Site Opportunities
Fluent in a language other than English?
Skills/Qualifications:
Physical/Medical Limitations:
(over)
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