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2. Disclaimer
   Information submitted on this form will be sent via unsecured email. To protect sensitive information, do not enter the following items or similar information on this form: Social Security numbers, driver’s license numbers, bank account information, routing numbers, credit card numbers, medical information, passport numbers, and passwords. Please review our privacy policy located at www.jeffco.us/privacy. By submitting this form, you acknowledge and accept the terms listed in the privacy policy.
4. First Name
   Type first name.
5. Last Name
   Type last name.
7. Street Address
   Type address here.
8. City
   Type city here.
9. State
   Type state here.
11. Preferred Phone Number
    Type your preferred phone number here.
12. Email address
    Type your email address here.
14. Why are you interested in volunteering with us?
16. I am interested in volunteering in the following way:

    1. Classroom helper (this is our greatest area of need): help teachers in the classroom reading to children, helping with activities, playing with children, etc.
    2. Library helper: Assist families in checking out books, log books back into the library system. No library experience required!
    3. Event helper: Help set up family events, help serving food, help cleaning up.
    4. Help on committees: provide input on our family events, health policies, etc.
    5. Food prep/Kitchen help: Assemble, serve, and clean up family style meals. Help run industrial dishwasher. **Any kitchen helper must have a current physical exam and TB test.**
    6. Fundraising helper: Solicit donations for our program, coordinate fundraising events, run fundraising "drives" to benefit our program (boot drives, coat drives, etc.)
    7. Facilities/Maintenance: Help with Landscaping and groundswork, help with repairing things around the site, painting, snow removal, etc.
    8. Specialty area: Do you have a trade or specialty that could enhance our program?
    9. Health Committee: Be a part of planning our health events, learn about our health screenings and their results. Meets 3 times/year.

    Please select the area in which you would like to volunteer.
18. How did you hear about our program?

    1. Driving by
    2. Family/Friend
    3. Website or Facebook
    4. Google search
    5. Other
20. If you checked "other" above, please describe how you heard about our program.
22. Most of our volunteer opportunities are in the morning (8-12) or afternoons (12-4). What is your availability?(Please check all that apply.)

    1. Monday morning
    2. Monday afternoon
    3. Tuesday morning
    4. Tuesday afternoon
    5. Wednesday morning

    1. Wednesday afternoon
    2. Thursday morning
    3. Thursday afternoon
    4. Friday morning
    5. Friday afternoon
24. All community volunteers in our program MUST be able to pass a background check.
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

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28. Submit

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