Volunteer Interest Form

Name *

First Name

Last Name

Phone *

(###)

###

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Are you interested in volunteering due to participation in a mandatory community service program(s)? *

Yes

No

Are you 18 years of age or older? *

Yes

No

Individual or Group? *

Individual

Group

Location: Where would you like to volunteer? *

You may choose more than one.

Madison County

Clark County

What type of volunteer opportunities are you interested in? *

You may choose more than one.

Build Site Construction

Home Repair Program

ReStore (assist customers, move/clean inventory, cash register)

Administrative (answer phones, data entry, accept mortgage payments, etc.)

Media (photography, videography, design, etc.)

Fundraising/Marketing

Can House Pick Ups (recycling program)

Do you have any physical limitations? *

Yes

No

Our primary way of communicating with volunteers is via email. Do we have your permission to email you about volunteer opportunities and updates? *

Yes, please sign me up to receive volunteer emails.

No, I do not wish to communicate via email regarding volunteer opportunities.