Heart of America - Books From The Heart Volunteer Application



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Home > Programs > Books From The Heart > Volunteer > Volunteer Application

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Note: * indicates a required field.

*Last Name:

*First Name:

Street Address:

City:

State:

ZIP Code:

*Telephone:

*Email:

Best way to reach you:

In the unlikely event of an emergency while you are volunteering, please provide an emergency contact name and phone number:

Present Occupation:

Present Employer:

*How did you hear about us?

Availability: (Check all that apply)

Weekly
Monthly
Project Specific Basis

Morning
Afternoon
Evenings

Volunteer Experience:

Name of Organization:
Dates of Service:
Supervisor:

Name of Organization:
Dates of Service:
Supervisor:

Volunteer Interests: (Check all that apply)

Organizing a Book Drive
Attending book distributions/Reading to children in the Gulf Coast area
Sorting & inventorying books in the Gulf Coast area
Transporting books in the Gulf Coast area (pick-up/delivery - requires own vehicle and valid drivers license)
Donation of in-kind services (printing, public relations, marketing, etc.)
What in-kind service are you offering?
Other interest areas:

Skills: (Check all that apply)

Typing/Clerical work Computer and/or graphic design skills	Public speaking Event planning
Other skills:

Why do you want to volunteer with the Heart of America Foundation?

Have you ever been convicted of an offense other than a minor traffic violation?

YES NO

Have you ever been arrested for any drug or sex related offenses?

YES NO

An affirmative response to the above questions will not necessarily bar you from volunteering. Volunteers who will be working with children may be subject to a criminal background check.

401 F Street NW, Suite 325
Washington, DC 20001
Tel: 202-347-6278 Fax: 202-347-8599