Volunteers helping with RISe Literacy Program

Volunteer Application Form

Thank you for your interest in volunteering.

Online: submit your application online by using the form below.

By mail or fax: If you prefer to submit your application by fax or mail, please download the pdf and use the address and fax number listed on the form. You will not be able to type your form and email it. You must fill out the applicationn form, print it and then mail it or fax it. Save the application pdf to your computer by right clicking and select "save link as."

* Indicates a required item

Education/Special Training:
Occupation:

Skills, Interests and Hobbies that may be helpful in your volunteer work (including foreign languages):

Current/Previous Volunteer Experience:

How did you hear about The Center for Hearing, Speech and Language?

Why are you interested in volunteering at the Center?

Areas/Programs that are of interest to you:  

RISE - early literacy program
KidScreen - hearing, speech and vision testing
Harmony - educational manikin
Board - time/fiduciary commitment

Days/Times you are available to volunteer
  Mon Tues Wed Thurs Fri Sat Sun
8am - 12pm
12pm - 4pm
4pm - 8pm

Emergency Contact:
Phone:
 
Please list two personal references:
Name:
Phone: Email:
Name:
Phone: Email:
By typing my name in the following box I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing my volunteer application.
Signature *: Date: