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If you would like more information on volunteer opportunities please fill out the form below and submit it. The United Way staff will review your information and reply with suggestions of volunteer opportunities that fit your needs, interests, and availability.

Full Name
Street Address
City
State	Zip
Phone Number
E-mail Address

I am	(click for list) Individual Adult Volunteer Individual Youth Volunteer (18 and under) Adult Group Youth Group Family

I have Transportation

Yes No

Availibility (check all that apply) Long Term (6 weeks or more) Short Term (6 weeks or less) Available for special Events Weekdays (daytime) Weekdays (evening) Weekends Put me on the on call list

I am interested in
(check all that apply)

Children and Youth Childcare/Early Childhood Education      Activities Children with Disabilities Crisis Youth Organizations Faith-based Youth Programs Parenting/Mentoring

Crisis Legal Firefighter Volunteer EMT, Emergency Advocacy Domestic/Sexual Violence                          Crisis Phone Operator Disaster

Community Support United Way Volunteer Information and Referral Services          Libraries History/Museums Board Member/Fund Raising Mediation

Health Hospital Volunteer       (50hr minimum commitment) Drug and Alcohol Services Mental Health/Retardation Services           Counseling Assisting people with disabilities Health Associations

Basic Needs Housing/Homelessness                          Food Services Literacy

Environment Recreation                                                  Nature Outside Work

Miscellaneous Clerical/Computer Animal services Arts/Theater Faith Based Building and Maintenance                       Donations

Aging Nursing/Rehab Centers Senior Centers Errands/Deliveries/Tasks Friendly Visitor

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