HAND Volunteer Application * 1. Please provide the following information: First and Last Name: Email: Phone Number: Street Address: City/State/Zip: * 2. Please briefly describe your experience with pregnancy/infant loss: * 3. If you have experienced a pregnancy/infant loss, please provide the date(s) of your loss(es) and name of baby/babies (if named): * 4. Do you have other children? Yes No If yes, names and ages: * 5. What is your experience with HAND? (check all that apply) Attended grief support meetings Attended subsequent pregnancy support meetings Received 1:1 peer support from a HAND volunteer Attended Service of Remembrance No prior experience with HAND Other (please specify) * 6. What are your volunteer interests? Support group meeting facilitator Peer support (1:1 support via phone and/or email) Board of Directors Event planning (Service of Remembrance, Volunteer Picnic) Administrative support Fundraising Technology (webmaster, data entry) Community outreach Newsletter Other (please specify) * 7. Please explain what you hope to contribute through your volunteer work with HAND: * 8. Do you have any special skills that you would like to offer in support of HAND? If so, please describe: * 9. Do you speak any other languages fluently? No Yes If yes, which language(s): * 10. Additional information you would like to relate (experience, concerns, questions)? Done