RSVP APPLICATION

Name (Last)

(First)

Address:

City, State, Zip:

Telephone Number:

Cell Phone Number:

Email Address:

Date of Birth:

What was your primary occupation?

How did you learn about RSVP?

Are you currently volunteering?

YES

NO

Where?

Select any type of volunteer duties you are interested in:

Services to Youth Senior / Older Person Programs Food Distribution School Programs Office Work Library Work Handyman Work

Yard Work, Planting Crime Prevention Committee Hospital Clean-up Projects Museums Hospice, Ombudsman

Other:

Describe any skills or hobbies you have that you feel would be helpful in your volunteer work:

What kind of time frame are you wanting to volunteer:

Once a week More than once a week One time - Short term project

Mornings Afternoon Other