Name and address

First name:

Last name:

Title:

Nickname:

Street 1:

Street 2:

Street 3:

City:

State:

* Zip: *

Home phone:

OK to call me here

Work phone:

OK to call me here

Cell phone:

* OK to call me here

Email address:

Demographic Information

Please provide the following information. It is used only to help us get a better idea of the demographic make-up of our volunteers.

Date of birth:

Gender:

VIRTUS Status

Please indicate where you are in the VIRTUS process. If you are unsure, please select "Unsure".

Type:

Other information:

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

Recruitment appeals

Availability

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

How would you like to help?

* Assignment Preference:

Cook AM only [Food Prep]

Donation Pickup [Food Prep]

Gardening at the Parish Kitchen [Building Support]

Maintenance [Building Support]

Morning Prep [Food Prep]

Organizing Storage Space [Building Support]

Server [Serving]

Emergency Contact Information

Please provide the contact information for at least one emergency contact.

1

2

First name:

Last name:

Home phone:

Work phone:

Cell phone:

Email address:

How did you hear about us?

I Agree

I understand and agree that submitting this application form does not automatically register me as a Parish Kitchen volunteer, and that there may be certain qualifications I must meet, including the acceptance of established volunteer policies and procedures before I may begin volunteering.

By submitting this form, I attest that the information I have provided on the form is true and accurate.

I understand that, to volunteer at Parish Kitchen, I am required to meet and maintain the requirements of VIRTUS and the "Protecting God's Children® for Adults" training. I understand that if I am not current in the program, I will be given the necessary information so that I can be.

I Agree