Course Instructor Feedback Form

Volunteer Areas of Interest;

	interested	Willing to learn	Neutral	Not Interested
Fundraising Events
Counting Donations
Stocking Shelves
Date & Bag Donations
Usher clients through pantry and assist with shopping
Front Desk, client greet and sign-in
Data Entry
Filing and Copying
Address envelopes and prepare Thank You's
Transporting Stock (Truck or Van required)
Assist at clothing outlet
Sacks of Snacks
Holiday Dinner Distribution
Serve on a committee
Warehouse work

PHOTO Release; The Clearinghouse has my permission to use general information and/or photos about my volunteer work for promotional purposes for The Clearinghouse programs and services.

AgreeDisagree
Emergency Contact

In case of emergency
Name

First NameLast Name
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
By submiting this form I am attesting that all my information is true and accurate and that I am not a robot but ther person completing this form....
Should be Empty:

Dearborn County Clearinghouse