Strengthening Families Volunteer Questionnaire
Name
*
First Name
Last Name
Maiden name or other aliases used in the past (required for OSBI background check):
*
Date of Birth (required for OSBI background check):
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Social Security Number (required for OSBI background check):
*
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
How would you like to support the Strengthening Families Program? (Select all that apply.)
Family Group Assistant (must have the ability to commit to at least 7 sessions)
Child Care Assistant (Children Ages 0-6)
Provide or Sponsor a Family Dinner
Are you signing up as an individual or on behalf of a group or organization?
Please Select
Individual
Business
Church/Faith Community
Other Organization
Organization or Group Name (if applicable)
What best describes your volunteer availability?
Please Select
Most or all Monday evenings
Several Monday evenings
Occasionally
I'm not sure yet. I need more information.
Select which dates you are available to volunteer:
Monday, September 28th
Monday, October 5th
Monday, October 12th
Monday, October 19th
Monday, October 26th
Monday, November 2nd
Monday, November 9th
Monday, November 16th
Monday, November 23rd
Monday, November 30th
Monday, December 7th
Monday, December 14th
Monday, December 21st
Do you have previous experience working with children or families?
Yes
No
Are you willing to complete a background check if required for your volunteer role?
Yes
No
How are you interested in supporting a family meal?
Prepare and provide a meal
Arrange for a catered meal
Financially sponsor a meal
I will not be donating any meals
How many meals are you interested in sponsoring or providing?
One Monday
More than one Monday
I'm flexible / would like to see available dates
Is there anything else you would like us to know about your interests, experience, availability, or how you would like to help?
Submit
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