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Volunteer Application
* Indicates Required Information

Our continued growth and success would not be possible without the help of others. To become a vounteer please fill out the form below and we will get in touch with you. From time to time we may also send out mailings or newsletters via the U.S. postal service. If you would like to be included in this list please enter your postal address information as well (optional).

Contact Information
   
First Name:
*
Last Name:
*
E-mail Address:
*
 
Postal Address:
City:
State:
Zip:
 
Home Phone:
Work Phone:
   
Availability
   
Please select the hours you would be available for volunteer assignments:
   
Weekday Mornings
Weekday Afternoons
Weekday Evenings
Weekend Mornings
Weekend Afternoons
Weekend Evenings
   
Interests
   
Tell us in which areas you are interested in volunteering:
   
Administration
Events
Field Work
Fundraising
Deliveries
Phone Bank
Newsletter Production
Volunteer Coordination
   
Special Skills or Qualifications
   

Summarize special skills and qualifications you have acquired from employment, previous volunteer work, or through other activities, including hobbies or sports.

   
Previous Volunteer Experience
   

Summarize your previous volunteer experience.

   
Person to Notify in Case of Emergency
   
Contact Name:
 
Postal Address:
City:
State:
Zip:
 
Phone:
   
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.

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.

   
 

 

You can contact us by mail Attn : John Vanover - 3080 Elrod Road - Somerset , Kentuky 42503
Email: vanover3@hotmail.com - Phone: (606)416-4543

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