Potential Volunteer Candidate Questionnaire

Winslow Therapeutic Riding Center

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* 1. First and Last Name

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* 2. Phone Number

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* 3. Email Address

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* 4. Have you ever volunteered at Winslow before?

Yes

No

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* 5. Please indicate any past participation you have had at Winslow.

Therapeutic Lessons

Traditional Lessons

Summer Adventures

Summer Youth Leadership Academy

Day at the Barn

Visiting Classroom

I have never participated in Winslow's programs

Other (please specify)

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* 6. Able to stand for at least 2 hours and walk for at least 30 minutes at one time?

Yes

No

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* 7. Able to lightly jog for at least 30 seconds at a time, and approximately 5 minutes total within a 30-minutes timeframe?

Yes

No

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* 8. Able and willing to perform barn chores WITHOUT the assistance of others, including but not limited to: cleaning stalls, sweeping, sanitizing, and cleaning tack?

Yes

No

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* 9. Volunteers MUST be independent in all functions, not require the assistance of others to engage in any activities, and have intact safety awareness. Do you require assistance in performing heavy work or being aware of your surroundings?

Yes

No

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* 10. After submitting this questionnaire, I understand that I must return to www.winslow.org/volunteertrail and complete steps 2-6.

Yes

No