KSSM VOLUNTEER FORM

KSSM Non-Profit Organization

Volunteer Application Form
KSSM is a 501(c)(3), nonprofit community outreach organization that is committed to bridging the gap between lack and need. We are dedicated to serving the community with as many resources, love, support, and assistance that can be offerred to assist during challenging times. KSSM thanks you for giving the seed of your time and serving to support the vision.

We encourage the participation of volunteers who support our
mission and are willing to contribute, be joyful and excited about being part of something wonderful. The information provided through this form will be kept confidential and will help us determine the most satisfying and appropriate volunteer opportunity for you.
Name*

First NameLast Name
Birth Date*

MonthDayYear
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Emergency Contact Name*

First NameLast Name
Emergency Contact Number*
Please enter a valid phone number.
In which areas would you like to volunteer?*
Are you signing up a group? If so, estimated attendees to serve.
Include the name of the Organization, Agency, Ministry, Etc….
Do you have any volunteering experience? If yes, please describe.
Do you have any known physical limitations?*

YesNo
How many pounds can you lift?*
Can you serve in outdoor conditions? Check all that applies.*

Somewhat hotExtremely hotSomewhat coldExtremely cold
From

Hour Minutes

AM/PM Option
To

Hour Minutes

AM/PM Option
AVAILABILITY

Check the possible dates that you might can serve
Days of Availability (Check all that Apply)*

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Preference of Shifts (Check all that apply)

MorningNoonEveningOther
Signature*

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Date*

MonthDayYear
Date
Should be Empty:

KSSM Non-Profit Organization

AVAILABILITY