ALL VOLUNTEERS MUST BE VACCINATED FOR VOLUNTEER SERVICE

DUE TO THE COVID 19 Crisis we are only accepting Applications for people that are vaccinated. Proof of Vaccination must be provided upon request..

Ms. Renelle Meristil, Volunteer Coordinator

718-574-0058 Ext 131 - rmeristil@breadandlife.org

St. Johns Bread and Life Program

795 Lexington Avenue - Brooklyn NY 11221

Name and address

First name:

Last name:

Title:

Street 1:

Street 2:

Street 3:

City:

State or Province:

* Zip: *

Home phone:

Work phone:

Cell phone:

Email address:

Date of birth:

Gender:

Emergency Contacts

Enter at least 1 Emergency Contact

1

2

First name:

Last name:

Middle name:

Street 1:

Street 2:

Street 3:

City:

State:

Zip:

Cell phone:

Relationship:

Availability

Please indicate the days and times you are usually available to volunteer.

[NOTE:EVENING PANTRY IS ON TUESDAY AND THURSDAY ONLY)

Mon

Tue

Wed

Thu

From:

To:

* Department:

Email Preferences

We like to keep volunteers informed of important news, schedules, and volunteer opportunities by email, however will not send you any email you prefer not to receive. Use the checkboxes below to select the kinds of email you would like to receive from us.

What kinds of email would you like to receive?

Electronic newsletters

Volunteer Opportunities

Directions

We are located at 795 Lexington Avenue Brooklyn NY 11221 between Patchen Avenue and Malcolm X Blvd.
The following public transportation is available
TRAIN - J train to Gates Avenue
BUSES - B15, B26, B46, B47, B52
Closest Expressway By Car - Jackie Robinson Expressway to Bushwick Avenue Exit
Copy and paste this link to our website for more detailed directions

http://www.breadandlife.org/contact-us.html

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I understand that if I am 18 years or younger I must be accompanied, and supervised, by an adult over 18 years of age.

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