The Refuge on Memorial Volunteer Interest Form
Thank you for your interest in serving with The Refuge on Memorial. We are grateful for your willingness to support our community. Please complete the form below so we can learn more about your availability and how you would like to serve. Once submitted, a member of our team will follow up with next steps and scheduling details.
Name
First Name
Last Name
Please Select Your Age Range
Under 18
18-25
25-30
30-40
40-50
50-60
60 and above
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Which days are you typically available to serve?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Which time slots are you available for?
Morning Support (7:00AM – 11:00 AM)
Mid Day Programming (11:00AM – 3:00 PM)
Evening + Intake (4:00 PM – 8:00 PM)
Late Support (8PM-12AM)
Flexible hours from 7AM-9PM
Are you available to serve on Saturday or Sunday during these time slots?
7AM-11AM
5PM-11PM
Flexible hours from 7AM-9PM
How often are you interested in serving?
Weekly
Bi-weekly
Monthly
As needed
Which areas are you interested in serving in? (Select all that apply)
Food Service (serving meals)
Food Preparation (preparing food off-site or bringing food)
Facilitating activities during the day
General support / wherever needed
Do you have any previous volunteer or work experience that may be helpful in this setting?
Do you have any additional skills, resources, or ways you’d like to contribute?
Please select one of the following
I am a highschool student
I am a college student
Neither
If the above is applicable, where do you attend?
Emergency Contact Name
Emergency Contact Phone Number
I understand that by submitting this form, I am expressing interest in volunteering with The Refuge on Memorial. I agree to communicate any changes in my availability and to follow all guidelines provided by the organization.
Yes
Submit
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