Volunteer Interest Form

ABRAZAR
7101 Wyoming Street, Westminster, CA 92683 Telephone (714)898-3581 Fax (714) 893-4819 Midway Community Center (MWCC) 14900 Park Lane, Midway City, CA 92655 B.volunteer@abrazarinc.com
We offer our volunteers, the opportunity to work with families in Orange County through programs that improve health and nutrition, socialization, lifelong learning, and economic self- sufficiency. We are Abrazar Inc. a multicultural, multigenerational community-based agency. We embrace, educate, and empower our community's youth, adults, and seniors. Abrazar volunteers are able to witness, first-hand, the importance of their contributions in the work that we do.

Contact Information (Required)
Name

First NameLast Name
Other Legal Names Used
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
E mail
example@example.com
Date of Birth: (month/day/year)

MonthDayYear
Date
Gender:

MaleFemaleTransgender Female to MaleTransgender Male to FemaleNon-binaryDecline to stateNot Listed please specify:
Race/Ethnicity

African American/BlackCaucasianLatinxAmerican Indian/Alaska NativeAsian IndianCambodianChineseFilipinoJapaneseKoreanLaotianVietnameseGuamanianHawaiianSamoanOther Pacific IslanderDecline to StateIf Not Listed Please Specify: _____________________________
Level of Education Completed:

Some HSHigh SchoolSome CollegeCollegeGraduate School
Are you currently enrolled in school?

YesNo
Emergency Contact:

First NameLast Name
Relationship:
Cell Number
Please enter a valid phone number.
Interests and Hobbies:(optional)
Availability (Required): Please include specific times in the table.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Do you have any physical limitations that might prevent you from completing your work?
Have you ever been convicted of a felony or misdemeanor?

YesNo
If yes, please explain
Are you volunteering to gain hours for probation?

YesNo
If yes, please explain
Programs Available: (Mark programs you are interested in)

P.R.I.D.E. Afterschool ProgramP.R.I.D.E. Summer Youth ProgramFood Distribution ProgramVITA Free Tax Preparation Program (Feb. - Apr.)Home Visiting ProgramSparkpointC.H.E.N.Special Events
Signature

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ABRAZAR