Tallgrass Volunteer Application
Name
*
DOB
*
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Month
-
Day
Year
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Address
*
City, State, Zip Code
*
Phone Number
*
Email Address
*
example@example.com
Sobriety Date or Al-Anon Start Date
*
-
Month
-
Day
Year
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Alumni: Program completion date
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Month
-
Day
Year
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Home group
*
Are you working with a sponsor?
*
Yes
No
Sponsor Name
*
Answer N/A if no Sponsor
What was your drug of choice?
*
Alcohol
Drugs
Both
Other: Al-Anon member
Volunteer Interest:
*
Outside meeting driver: Tuesday evening, Thursday evening, Saturday morning or evening (60 days sobriety required)
Mentoring: 3 days a week (Firm requirements: Have gone through the steps & currently have a sponsor)
Big Book Group Meetings: Mon-Fri 10am-11:30am (Firm Requirements: Have gone through the steps & currently have a sponsor)
Evening AA/NA group Meetings: M/W/F 7-8pm
Weekend AA/NA group Meetings: Sat/Sun 1:30-2:30pm; Sun 10:30am
5th Steps
Al-Anon Speaker Meeting: Saturday 1:30
Days Available
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Frequency or Limitations? Available for a reccurring monthly meeting?
*
Because of the nature of our business and relationship, we need to ask if you are an individual who is or should be registered on ANY sex offender registry in ANY state or federal jurisdiction.
*
Yes
No
Submit
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