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SHS Volunteer Application

Thank you for your interest in becoming an SHS volunteer.

Please complete this questionnaire so we can best match your interests with current volunteer opportunities at Swope Health Services.

Question Title

* 1.

Volunteer Contact Information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Why do you want to volunteer at Swope Health Services?

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* 3. Many community events are held in the evenings and on weekends. Are you willing to work during these times?

Yes

No

Maybe--it depends on how much notice I get.

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* 4. Please rank your comfort level with the following tasks:

	Very Uncomfortable	Uncomfortable	OK, though it's not an activity I enjoy	Comfortable	Very Comfortable
Public Speaking/Presentations	Public Speaking/Presentations Very Uncomfortable	Public Speaking/Presentations Uncomfortable	Public Speaking/Presentations OK, though it's not an activity I enjoy	Public Speaking/Presentations Comfortable	Public Speaking/Presentations Very Comfortable
Interacting with Adults	Interacting with Adults Very Uncomfortable	Interacting with Adults Uncomfortable	Interacting with Adults OK, though it's not an activity I enjoy	Interacting with Adults Comfortable	Interacting with Adults Very Comfortable
Interacting with Children	Interacting with Children Very Uncomfortable	Interacting with Children Uncomfortable	Interacting with Children OK, though it's not an activity I enjoy	Interacting with Children Comfortable	Interacting with Children Very Comfortable
Interacting with the Elderly	Interacting with the Elderly Very Uncomfortable	Interacting with the Elderly Uncomfortable	Interacting with the Elderly OK, though it's not an activity I enjoy	Interacting with the Elderly Comfortable	Interacting with the Elderly Very Comfortable
Interacting with the Homeless	Interacting with the Homeless Very Uncomfortable	Interacting with the Homeless Uncomfortable	Interacting with the Homeless OK, though it's not an activity I enjoy	Interacting with the Homeless Comfortable	Interacting with the Homeless Very Comfortable
Interacting with people with disabilities	Interacting with people with disabilities Very Uncomfortable	Interacting with people with disabilities Uncomfortable	Interacting with people with disabilities OK, though it's not an activity I enjoy	Interacting with people with disabilities Comfortable	Interacting with people with disabilities Very Comfortable
Staffing an information booth at a community event	Staffing an information booth at a community event Very Uncomfortable	Staffing an information booth at a community event Uncomfortable	Staffing an information booth at a community event OK, though it's not an activity I enjoy	Staffing an information booth at a community event Comfortable	Staffing an information booth at a community event Very Comfortable
Assisting with fundraisers	Assisting with fundraisers Very Uncomfortable	Assisting with fundraisers Uncomfortable	Assisting with fundraisers OK, though it's not an activity I enjoy	Assisting with fundraisers Comfortable	Assisting with fundraisers Very Comfortable
Answering or placing phone calls	Answering or placing phone calls Very Uncomfortable	Answering or placing phone calls Uncomfortable	Answering or placing phone calls OK, though it's not an activity I enjoy	Answering or placing phone calls Comfortable	Answering or placing phone calls Very Comfortable
Preparing mailings	Preparing mailings Very Uncomfortable	Preparing mailings Uncomfortable	Preparing mailings OK, though it's not an activity I enjoy	Preparing mailings Comfortable	Preparing mailings Very Comfortable
Giving tours to potential and current donors	Giving tours to potential and current donors Very Uncomfortable	Giving tours to potential and current donors Uncomfortable	Giving tours to potential and current donors OK, though it's not an activity I enjoy	Giving tours to potential and current donors Comfortable	Giving tours to potential and current donors Very Comfortable
Working outdoors	Working outdoors Very Uncomfortable	Working outdoors Uncomfortable	Working outdoors OK, though it's not an activity I enjoy	Working outdoors Comfortable	Working outdoors Very Comfortable
Standing for long periods of time	Standing for long periods of time Very Uncomfortable	Standing for long periods of time Uncomfortable	Standing for long periods of time OK, though it's not an activity I enjoy	Standing for long periods of time Comfortable	Standing for long periods of time Very Comfortable
Providing information according to a script	Providing information according to a script Very Uncomfortable	Providing information according to a script Uncomfortable	Providing information according to a script OK, though it's not an activity I enjoy	Providing information according to a script Comfortable	Providing information according to a script Very Comfortable

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* 5. Is there anything else you would like to share as it relates to your interest in becoming an SHS volunteer?