Labor Day Auction Volunteer Application Form
Please complete this application form if you are interested in becoming a Hospice & Community Care volunteer for our Labor Day Auction. Once you complete the form, click the submit button at the bottom.
Demographics
First name:
*
Last name:
*
Title:
Choose
Dr.
Miss
Mr.
Mrs.
Ms.
*
Street 1:
*
Street 2:
Street 3:
City:
*
State:
Choose
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
*
Zip:
*
Preferred Phone Number phone:
*
Email address:
*
Date of birth:
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
1
2
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31
Year
2022
2021
2020
2019
2018
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2016
2015
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2012
2011
2010
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2003
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1971
1970
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1967
1966
1965
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1963
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1948
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1944
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1939
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1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
(year optional)
Gender:
Choose
Female
Male
Emergency Notification
First name:
*
Last name:
*
Title:
Choose
Dr.
Miss
Mr.
Mrs.
Ms.
Street 1:
Street 2:
Street 3:
City:
State:
Choose
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
Preferred Phone Number phone:
*
Relationship:
Choose
Brother
Cousin
Co-worker
Daughter
Domestic Partner
Father
Friend
Mother
Neighbor
Nephew
Niece
Other
Sister
Son
Spouse
Supervisor
*
Employment
Employer name:
Please note your job title here. If you are retired, please note your retirement date here:
Special Skills and Interests
*
Skills:
Animal Lover
Auctioneer
Church Activities
Clerical
Comfort Touch
Computer
Cooking / Baking
Counseling
CPR
Gardening
Hairdresser - Licensed
Hunting / Fishing
Intern
Military
Music
Nursing
Other (Check Notes)
Photography
Public Speaking
Reading
Receptionist
RN - Licensed
Sewing / Quilting / Knitting
Social Work
Sports
Writing
Other skills - please list:
Other Volunteer Experience
Please list any other volunteer experiences you've had (include role, agency, dates volunteered and activities completed):
Additional Details
Do you have your own transportation?:
Please list any hobbies, activities, community clubs, etc. you have/belong to:
Agreement
Your signature indicates to the truthfulness of this information.
I Agree
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