Easterseals NH/VT/Farnum Volunteer Interest Form

Easterseals NH/VT/Farnum

Volunteer Interest Form

First Name*

Last Name*

E-Mail Address*

Address

Phone Number

Phone

Have you volunteered with Easterseals before?*

Select

In what capacity?

Are you interested in volunteering as an individual or with a group?*

Individual

Group

Group, Organization or Company Name

Are you looking for certified volunteer hours?*

Select

How many certified hours are you looking to complete with Easterseals?

When do you need to complete your hours by?

What area of the agency are you interested in volunteering?*

Senior Services

Child Development Center

Administration

Veterans Count

Events

Camp Sno-Mo

Wherever I'm needed most!

Other

Emergency Contact Name*

Emergency Contact Phone Number*

Phone

Additional Comments:

Send me a copy of my responses