Crossroads Shelter • Volunteer/Intern Application

Name:

Date of Birth: ____ / _____ /_____

Address:

City:                       State:               Zip:

Home Phone #:

Other Phone #:

Email address:

Occupation/Employer:

Interests, skills, hobbies:


Have you ever done volunteer work before?  □ Yes  □ No

Where?

What kind?

What kind of volunteer work would you like to do?
□ Fundraising □ Presentations □ Maintenance  □ Lawn Care  □ Renovations □ Special Projects
□ Other:

How much time can you give?
Weekly: _________ Monthly: __________

Available times:

Why do you wish to volunteer for Crossroads Shelter?


Where did you hear about us?


Name, address, and phone # of a personal reference:



Other information you wish to share about your talents or interests (use back of paper, if needed):



Mail to: PO Box 117 • Wytheville, VA 24382