Volunteer Interest Form

Volunteer Interest Form

The first step to becoming a James Samaritan!
A James Samaritan is one who sees the needs of our children and families and responds. Together, we will mobilize and equip our community to meet the critical needs of foster children and youth in transition. We will create a culture in which our most invisible and vulnerable are supported and empowered.

We encourage the participation of volunteers who support our
mission and are willing to work as part of team. The information provided through this form will be kept confidential and will help us determine the
most appropriate volunteer opportunity for you. Thank you!
Name*

PrefixFirst NameLast Name
Birth Date

MonthDayYear
Email*
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you attend a local church?*

YesNoOther
If Yes, which one?
Educational Background
Occupation
In which areas would you like to volunteer?*
Do you have any volunteer experience? If yes, please describe.*
What motivated you to inquire about volunteering with us?
Select your available days
From

:HourMinutesAM/PM Option
To

:HourMinutesAM/PM Option
Date

MonthDayYear
Date
Signature
Should be Empty: