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A Process
A State of Mind

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VOLUNTEER FORM

Please complete the form.

Volunteer Contact Information

Name*

Street Address*

Optional Address Line (building and/or suite number, etc):

City *

State *
Select Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland and Labrador North Carolina North Dakota Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon
Zip*

Home Phone*
(xxx-xxx-xxxx)

Work Phone
(xxx-xxx-xxxx)
Cell Phone
(xxx-xxx-xxxx)

E-mail Address*

Check the best way to contact you: Home phone Work phone Cell phone E-mail

Please briefly describe your previous volunteer experience (if any) and your motivation for wanting to work with O'Connor House as a volunteer:

Please provide your Employment Experience (Start and End Dates, Employer Name, City, State and your Job Title):

Please provide us with your Education Background:

Please provide 2 local references:

Name
Phone Number
E-mail Address

Name
Phone Number
E-mail Address

If you are requesting assignment to a specific O'Connor House project or committee,
please designate below.

Project or Committee Name
Who recruited you for this committee

Please check the area(s) in which you would like to volunteer.

As Needed	Communications	Research	Fundraising
Office/Admin asst.	Committee support	Events	Specific Projects
KeyV – this is a volunteer position that serves as a "hub" for an ongoing committee or project. The KeyV attends most committee or project meetings, may be responsible for meeting notes, follow-up, correspondence, recruiting and managing the volunteers and other duties as needed by the project or committee.

Please check the skills you will be contributing:

IT/Technical/Computer skills	Preparing Presentations	Research/Writing
Interviewing/Observation	Policy Development	Related Education/Training
Tracking Legislation	Communications (writing/phone)	Office / Administrative Skills
Other	Grant Writing	Microsoft Office

How many hours can you devote per week? When can you start?

Are there any specific dates that you will not available?

Please check the days and times that you may be able to volunteer (if you have a preference):

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
8:00am to Noon
Noon to 5:00pm
5:00pm to 9:00pm

Do you have any special needs or accommodations that we should know about or that we need to be aware of so that you can perform your volunteer duties?