Volunteer Interest Form Question Title * 1. Name: Question Title * 2. Address Information: Address: Address 2: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Question Title * 3. What phone number would be the best for contacting you? Question Title * 4. At what email address would you like to be contacted? Question Title * 5. What is the name of the school closest to your home? Question Title * 6. What days are you available? Please note all that apply. Monday Tuesday Wednesday Thursday Friday Saturday Sunday Question Title * 7. What time of day are you available? Please check all that apply. Morning (9am-12pm) Afternoon (1pm-4pm) Evening (6pm-10pm) Question Title * 8. Do you have reliable transportation? Yes No Question Title * 9. How far are you willing to drive? Please check the furthest distance. 1 mile 5 miles 10 miles 30 miles 50+ miles Other (please specify) Question Title * 10. In what languages can you speak, write or read? (Check all that apply) English Spanish Other (please specify) Question Title * 11. If currently attending college, what is your college major? Question Title * 12. What time of year are you available to volunteer? Check all that apply. Fall Winter Spring Summer Question Title * 13. Would you like to work with adults or girls? Girls Adults Both Question Title * 14. If girls, what grade levels would you be most comfortable assisting? Please check all that apply. Kindergarten-1st Grade 2nd - 3rd Grade 4th - 5th Grade Middle School High School Question Title * 15. What are your favorite things to do, ex. science, math, reading, dance, art, music? Question Title * 16. What specific skills do you have (ie. sewing, cooking, knitting): Question Title * 17. Any Other Details (not mentioned above): Done