• About Volunteering at ASB
• Application Form

Date:__________

Name:_________________________________________________
Phone:_______________ Birthday:________________

Address:___________________________________ Apt:_____
City:_____________ State:_____ ZIP:________

Occupation:______________________________
Place of Employment: ___________________________

May we contact you at work? _____ Yes-No_____
Business Phone:___________________

Emergency Contact:_________________________________
Relationship:______________________
Phone:____________________

Schooling and Training:
Highest Level of Education_________________________________________

Specialized Training (Be Specific) ______________________________

____________________________________________________________

Have you ever done volunteer work before _____ Yes - No _____

If Yes, where? __________________________________________

Location:________________________________________
Responsibilities:___________________________________

Hobbies, Interests, & Special Skills:________________________________________

What is your most convenient time for volunteering?
Weekdays _____ Mornings_____ Afternoons______ Evenings_____ Weekends _____ Mornings_____ Afternoons _____ Evenings _____
(* No weekend hours for Radio & Recording Department)

What type of work would you enjoy doing?
Reader In Home _____ Office Reader For Professional_____ Computer Training_____ Braille Transcriber_____ *Radio Narrator_____ *Tape Narrator_____ Stuffing Envelopes_____ Other_______________________________________________________

Do you have any medical problems, which would limit the type of volunteer work you do?
__________________________________________________

References:
Name:_________________________________
Address______________________________
Phone:__________________

Name:______________________________
Address______________________________
Phone:__________________

How did you hear about volunteering for ASB?
__________________________________________________________________________

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