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    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.

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

    MorningAfternoonEvening
    MorningAfternoonEvening
    MorningAfternoonEvening
    MorningAfternoonEvening
    MorningAfternoonEvening
    MorningAfternoonEvening
    MorningAfternoonEvening


    Clinic Hours/Shifts: Sunday 12pm - 3pm and Wednesday, 5pm - 8pm. What Shift are you available to volunteer?


    I certify that all the statements herein on this volunteer information sheet are true and correct and have been given voluntarily. I understand that this information may be shared with any legal and proper interest, and I release the agency from any liability whatsoever for supplying such information. I understand I will not be paid for my services in my volunteer capacity. I agree to abide by the Place of Hope Inc policies and procedures.

    I also allow the Place of Hope Inc to use my picture(s) and/or comments for newsletters, public relations mailings and for any other Place of Hope related, legitimate purpose."

    I Agree

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