Name:

Address1:

Address2:

City:

State:

Zip:

Phone #:

E-mail:

I am interested in volunteering with People Incorporated because:

I am available for volunteering at the following times:

My talents/skills:

How did you find out about People Incorporated?

Arts/crafts assistant

Clerical, data entry

Driver

Group facilitator

Handy person

Host for special events

Medical records clerk

Mentor

Office assistant

Phone buddy

Receptionist

Recreational assistant

Seamstress or sewing teacher

Special events team member

Other: