EmailMe Form - Sheltering Arms Group Volunteer Application

Name *

First Last

Company or Group Name *

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Email *

Best number to reach you

### - ### - ####

Areas of Interest: *

What location are you interested in volunteering at? *

What days are you interested in volunteering? *

To select more than one day, press and hold down the Ctrl key, and then click each day that you want to select.

Do you have a certain date or date range in mind?

If yes, please enter that information in the box above

What time of day are you available for volunteering? *

Groups 9:00 am - 11:00 am

Groups 2:00 pm - 5:00 pm

Group volunteer opportunities are from 9:00 am - 11:00 am or 2:00 pm - 5:00 pm.

How often do you plan on volunteering? *

Other than traffic violations, does anyone in your group have any criminal convictions? *

No

Yes

If yes, please provide more information:

Do you or anyone in your group have any physical limitations or require any special accommodations? *

No

Yes

If yes, please provide details below:

Does anyone in the group speak any languages other than English? *

No

Yes

If yes, please specify what languages:

Does your group have previous volunteer experience? *

No

Yes

If yes, please list where the group has volunteered at previously:

Do you (or anyone in the group) have any of the following? Please select all that apply:

First Aid

CPR

Pediatric CPR

Does the group have any special skills, interests, or qualifications that we should know about?

Please let us know if you have any other questions, comments or concerns:

*

I certify that the information listed on this form is complete and correct.