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Application for Volunteer Service

Tell us about yourself:
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Today's Date:*
MM slash DD slash YYYY
First Name:*
Last Name:*
Street Address:*
Address Line 2:
City:*
State:

CONNECTICUT
ZIP Code:*
Home Phone:*
Work Phone:
Cell Phone:
Email:*
Age Range:*
Birth Date: (OPTIONAL – month and day only)
Month
Day
Previous Employer:
Current Employer:
Person to notify in an emergency:
Phone:
How did you hear about Read to Grow?
Education level reached:
If other, please specify:
Please list any languages you are fluent in other than English:
Have you had any prior volunteer experience?
- Yes
- No
If yes, please explain:
Volunteer Jobs — Please indicate all the areas in which you are interested in volunteering (select all that apply):
Office / Computer Work
- Prepare mailings
- Assemble program materials
- Data entry
- Development/grant work
Books for Kids
- Count and sort donated books
- Pick up and deliver books
- Pack book requests
Books for Babies
- Visit with families (trained through Hospital Volunteer Services)
- Assemble baby packets
Special Events
- Assist with special events
- Staff special events
Are you willing to be called in on short notice?
- Yes
- No
Do you have any physical or psychological conditions or handicap that may affect your ability to perform certain volunteer assignments?
- Yes
- No
If yes, please explain:
Do you have any lifting restrictions?
- Yes
- No
If yes, please explain:
Have you even been convicted of a crime?*
- Yes
- No
Comments
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53 School Ground Road Branford, CT 06405 203.488.6800 [email protected]

HOURS OF OPERATION
Monday–Friday, 9am–5pm EST

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Application for Volunteer Service

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