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Volunteer Interest Form
Thank you for being interested in being a volunteer at Mazzoni Center. Fill out the information below:
Your Contact Information
Name
*
First
Last
Pronouns
*
He/Him
She/Her
They/Them
Other
Email
*
Phone
###
-
###
-
####
Are you volunteering as part of a group from your school or workplace?
*
Yes
No
Name of your school or workplace
Availability
Availability to Volunteer
*
Weekdays Morning
Weekdays Afternoon
Weekdays Evening
Weekends Morning
Weekends Afternoon
Weekends Evening
Preferred Volunteer Locations
*
Onsite Mazzoni Center Bainbridge
Onsite Mazzoni Center Washington West
Offsite at Community Events
Virtually
Interest Volunteer Areas*
*
Fundraising
Assembling Safer Sex or Hygiene Kits
Communications or Marketing Support
Front Desk Reception Welcome Visitors Patients
Skills
Select any of the following skills you possess *
*
Word Processing
Data Entry
Manual Labor
Marketing
Fundraising
Event Planning
Landscaping
Customer Service
Are there any specialized professional skills you possess that you’d like to use while volunteering at Mazzoni Center?
What (if any) professional certifications do you have?
Demographics
Please provide your demographic information if you feel comfortable doing so
Race
*
Asian
Black/ African American
Latin(o)(a)(x)
Native American
Pacific Islander
White
Other
Sexual Orientation
*
Gay
Lesbian
Bisexual
Pansexual
Straight
Queer
Other
Gender Identity
*
Cis Female
Trans Female
Cis Male
Gender non-binary
Gender non-conforming
Trans Male
Other