Personal Information

Name
(First, Middle, Last)

Address


City
State
Zip Code

Home Phone


Cell Phone

Work Phone

E-mail


Are you over 18 years of age?
Yes
No

Occupation


Employer


Would you be interested in volunteering as a family?



References (please list two personal references other than family)

Name


Name
Phone


Phone

Are you willing to let The Rainbow Connection do a police clearance?



General Information

Are there any special skills or training that you would like to share with The Rainbow Connection?


What are your current interests and hobbies?


Is there a particular area of volunteer work in which you are interested?
(please check all that apply)
Events and Benefits
Office and General Duties
Assistant / Directly Assisting Staff Person
Newsletter
Speakers' Bureau
Gardening
No Preference
Other

What days and times are you available to volunteer?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

How did you hear about The Rainbow Connection?
Referred by friend / volunteer
Referred by Wish Family
Advertisement (if so, where?)
Other