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* 1. Indicate your level of interest to volunteer with Crosshatch (5 stars = I want to connect immediately!)

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* 2. How much time in hours are you hoping to offer each month for Crosshatch volunteer duties?

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* 3. Name

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* 4. Address

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* 5. Phone Number

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* 6. Email

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* 7. What is it about Crosshatch that has attracted you to us?

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* 8. What is your current occupation or pursuit?

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* 9. Who are you employed by or working with?

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* 10. What skills of yours are you most interested in sharing with Crosshatch?

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* 11. Are there new skills you'd like to develop though this volunteer engagement opportunity?

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* 12. Do you have previous volunteer experience? If yes, who and what organizations have you supported? What were your primary roles?

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* 13. List two personal or professional references related to the skills you are willing to share, who we may call if needed.

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* 14. Emergency contact information - Name, Relationship, Phone Number.

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* 15. Dietary restrictions

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* 16. (Optional at this time) Allergies

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* 17. If need be, do we have your permission to conduct a background check?

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* 18. Before taking on activities with physical demands I would like to discuss my comfort and ability with the Volunteer Coordinator.

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* 19. Check when you are available (mark all that apply).

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* 20. Where are you willing to volunteer? (mark all that apply)

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